Transoral endoscopic approach versus transcervical with or without mandibular swing approach to parapharyngeal space- a retrospective cohort study in a tertiary care center in Tamil Nadu

<p class="abstract"><strong>Background:</strong> The objective of this study was to evaluate and compare patient outcomes and advantages of endoscopic transoral approach to parapharyngeal space with other approaches like transcervical with or without mandibular swing approach.</p><p class="abstract"><strong>Methods:</strong> In this retrospective cohort study, we have reviewed 13 cases of parapharyngeal space tumors resected with either trans oral endoscopic assisted approach or external approaches such as trans cervical and mandibular swing approach during the period of June 1, 2015 to May 31, 2020. </p><p class="abstract"><strong>Results:</strong> A total of 13 cases were included in the study. Among 13 cases, 9 were operated by transoral endoscopic approach, 2 by transcervical approach and 2 by transcervical with mandibular swing approach. Operative time (p=0.048), blood loss (p=0.028), hospital days (p=0.02) and postoperative patient satisfaction (p=0.008) were more in transoral route compared to transcervical route.</p><p class="abstract"><strong>Conclusions:</strong> Transoral endoscopic route is a safe route of surgery with less morbidity, less complications, less chance of neurovascular injury and cosmetically more acceptable for the patient when compared to open procedures for smaller size tumors without vascularization, present in the upper part of the parapharyngeal space and without attachment to any neurovascular structures.</p>

Carcinoma ex Pleomorphic Adenoma in the Parapharyngeal Space

Objective: To present a case of carcinoma ex pleomorphic adenoma in the parapharyngeal space and discuss its management. Methods: Design: Case Report Setting: Tertiary Government Teaching Hospital Subjects: One Results: A 40-year-old male patient with dysphagia for three months and a left-sided mucosa-covered oropharyngeal mass was found to have a prestyloid parapharyngeal lesion on CT Scans. Fine Needle Aspiration Cytology (FNAC) revealed a pleomorphic adenoma. With a past history of parapharyngeal pleomorphic adenoma excised transorally three years before, the present mass was excised by mandibular swing approach. Post-operative recovery was uneventful, but the final histopathological report was carcinoma ex pleomorphic adenoma. Conclusion: Malignant transformation should be suspected in recurrent salivary tumors in the parapharyngeal space. Provided there was truly no pre-existing malignant focus in the originally-excised tumor, and that early recurrence was not due to inadequate initial excision, this patient had a rare condition where the same tumor underwent malignant transformation within 3 years only. To the best of our knowledge, such an early transformation to malignancy of a minor salivary gland tumor of the parapharyngeal space has not been reported in the English literature. Keywords: carcinoma ex pleomorphic adenoma, pleomorphic adenoma, carcinoma, parapharyngeal space, malignant, transformation, minor salivary gland tumor, mandibular swing

Removal of Angiofibroma with Maxillary and Mandibular Swing: A Clinical Report

ABSTRACT Juvenile nasopharyngeal angiofibroma is vascular tumor found in adolescent males. With development of endoscopic fraternity, tumor can be addressed successfully with endoscopic approach; but one needs maximum exposure for large angiofibroma with local infiltration around. Maxillary and mandibular swing technique for removal of the tumor gives excellent exposure and good control on vascularity of the tumor. Postoperative follow-up for 1 year has shown minimal visible scar, cosmetic deformity in the patient.

Removal of Angiofibroma with Maxillary and Mandibular Swing: A Clinical Report

ABSTRACT Juvenile nasopharyngeal angiofibroma is vascular tumor found in adolescent males. With development of endoscopic fraternity, tumor can be addressed successfully with endoscopic approach; but one needs maximum exposure for large angiofibroma with local infiltration around. Maxillary and mandibular swing technique for removal of the tumor gives excellent exposure and good control on vascularity of the tumor. Postoperative follow-up for 1 year has shown minimal visible scar, cosmetic deformity in the patient. How to cite this article Ghorpade CV, Deo RP, Thorat RD, Devane SD. Removal of Angiofibroma with Maxillary and Mandibular Swing: A Clinical Report. Int J Otorhinolaryngol Clin 2012;4(3):151-155.