From transmandibular to transoral robotic approach for parapharyngeal space tumors

被引:40
作者
Chu, Francesco [1 ,2 ]
Tagliabue, Marta [1 ,2 ]
Giugliano, Gioacchino [1 ,2 ]
Calabrese, Luca [1 ,2 ]
Preda, Lorenzo [3 ]
Ansarin, Mohssen [1 ,2 ]
机构
[1] European Inst Oncol, Dept Head & Neck Surg, Via Ripamonti 435, I-20141 Milan, Italy
[2] European Inst Oncol, Otorhinolaryngol, Via Ripamonti 435, I-20141 Milan, Italy
[3] Univ Pavia, Dept Clin Surg Diagnost & Pediat Sci, Natl Ctr Oncol Hadrontherapy, CNAO Fdn, Str Privata Campeggi 53, I-27100 Pavia, Italy
关键词
MANDIBULAR OSTEOTOMY; CASE SERIES; MANAGEMENT; SURGERY; NERVE;
D O I
10.1016/j.amjoto.2017.03.004
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Purpose: Parapharyngeal space (PPS) tumors are rare, accounting for 0.5% of all head-and-neck masses. Surgery remains the standard treatment for most cases, including different approaches (cervical approach, parotidectomy, mandibulotomy, transoral/robotic). We report our experience in the management of PPS tumors, aiming to create a surgical algorithm on the base of tumor's radiological and clinical characteristics. Materials and methods: Critical retrospective analysis of patients with PPS neoplasms who underwent surgery at our Institute. Data were collected on patient age and sex, tumor location and size, preoperative investigations, surgical approaches, histopathology, complications and outcomes. Results: Between January 2000 and July 2015, 53 patients were treated at our Institute. Salivary gland tumors were the most common neoplasms followed by neurogenic tumors. Cr scan/MRI were the most used preoperative imaging studies. The cervical approach with or without parotidectomy is the most used, providing the best compromise between the need for radicality and low risk of damage to the neurovascular structures. Mandibulotomy is used whenever the mass extends to the cranial base, assuming a higher morbidity, a slower functional recovery and the need for tracheotomy. Recently, TORS has been used for tumors of the PPS with promising outcomes. Conclusions: PPS surgery includes a wide spectrum of approaches but it is still a matter of debate which one guarantees better functional and oncological outcomes. We report a surgical algorithm based on surgical invasiveness and tumor characteristics to standardize PPS tumors management. We also highlight the upcoming role of TORS in this field. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:375 / 379
页数:5
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