Management of tumors arising from the parapharyngeal space: A systematic review of 1,293 cases reported over 25 years

Abstract

Objectives: We present a systematic review of 1,252 lesions published in the past 25 years, the largest to date. We also include our own experience of 41 cases.

Data sources: Our data sources were MEDLINE and Embase databases.

Review methods: A systematic review of the literature (1988-2014) was performed and data on histological diagnosis, presentation, surgical approach, and postoperative complications were reviewed.

Results: In total, 22 studies (including our own institution) revealed 82% of lesions were benign. The most common presentation was an intraoral mass (52%) followed by a cervical mass (48%), and the most common primary lesion was a pleomorphic adenoma (29%). Ninety-six percent of patients underwent surgery. The cervical approach was most frequently used (46%), and the most common complication was vagus nerve injury (13%). Within our institution, 5-year progression-free survival for benign and malignant disease was 93% and 61%, respectively (P = .196).

Conclusions: A parapharyngeal space mass is an uncommon tumor and requires careful preoperative assessment. Definitive treatment is usually surgery, and these patients should be counseled appropriately about the potential for permanent cranial nerve deficits.

Level of evidence: NA.

Keywords: Parapharyngeal space lesion; complications; pathological classification; recurrence; surgical approach.