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. 2022 Dec;74(Suppl 3):5794-5799.
doi: 10.1007/s12070-021-02385-3. Epub 2021 Jan 30.

Management of a Giant Para-Pharyngeal Space Pleomorphic Adenoma of Deep Lobe of Parotid Gland Without Mandibular Swing Approach in a 17-Year Old Patient: Rare Case Report

Pranav Ingole  1 , Jignesh Rajguru  1 , Rajcee Chhajed  2 , Rasika Jadhav  3 , Jui Karmarkar  1 , Ramakrishna Shenoi  1
Affiliations

Management of a Giant Para-Pharyngeal Space Pleomorphic Adenoma of Deep Lobe of Parotid Gland Without Mandibular Swing Approach in a 17-Year Old Patient: Rare Case Report

Pranav Ingole et al. Indian J Otolaryngol Head Neck Surg. 2022 Dec.

Abstract

Pleomorphic adenomas comprise of 0.5% of all head and neck tumors. Pleomorphic adenoma affects patients from 4th to 6th decades. 10-12% of Pleomorphic adenomas arise from deep lobe of parotid gland that grow medially and involve the parapharyngeal space. Investigations play a role of paramount importance in treatment of para-pharyngeal tumors. CT scanning aids in evaluating the bone structures and possible calcification of the tumors. MRI provides precise tumor margins and the relationship of the tumor with its adjacent vital structures. The most common approaches to access these masses are the trans-oral, trans-mandibular, transcervical and trans-parotid trans-cervical approaches. Complete surgical excision of the lesion is the treatment of choice for such PPS tumors. The choice of surgical approach should enable the surgeon to maximize exposure for complete resection of the tumor while minimize functional and cosmetic morbidity. The various mandibulotomies are median mandibulotomy, para-symphyseal osteotomy, horizontal osteotomy, inverted 'L' osteotomy and double mandibular osteotomy. We report a rare case of giant pleomorphic adenoma arising from the deep lobe of parotid gland of the parapharyngeal space in a young patient. The excision was done in to without the mandibular swing approach making it one of the rare case reports.

Keywords: Mandibular swing approach; Para-pharyngeal space; Pleomorphic adenoma.

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Conflict of interest statement

Conflicts of interestThere are no conflicts of interest.

Figures

Fig. 1
Fig. 1
An intra-oral swelling involving the retromolar trigone and soft palate region
Fig. 2
Fig. 2
A space occupying lesion likely arising from the deep lobe of the parotid gland
Fig. 3
Fig. 3
A well marginated soft tissue lesion in the pre-styloid compartment of right parapharyngeal space
Fig. 4
Fig. 4
The incision for the apron flap was marked on the skin
Fig. 5
Fig. 5
The skin and platysma were raised to the lower border of the mandible
Fig. 6
Fig. 6
Mobilization and upward reflection of gland exposed the para-pharyngeal mass
Fig. 7
Fig. 7
After careful dissection, removal of the submandibular gland was done
Fig. 8
Fig. 8
Excision in toto
Fig. 9
Fig. 9
Excision in toto
Fig. 10
Fig. 10
Histopathological examination was suggestive of Pleomorphic adenoma of salivary gland
See this image and copyright information in PMC

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