Parapharyngeal Space Tumors: Our Experience

Abstract

Para-pharyngeal space (PPS) tumors include an heterogeneous group of neoplasms, accounting for approximatively 0.5-1.5% of all head and neck tumors. Management of these neoplasms requires a careful diagnostic workout and an appropriate surgical approach to obtain good outcomes associated with minimal aesthetic drawbacks. In this study we investigated clinical onset, histologic features, surgical treatment outcomes, peri operative complications and follow up of 98 patients treated for PPS tumors in our Centre between 2002 and 2021. Furthermore, we reviewed our preliminary experience of preoperative embolization of hyper vascular PPS tumors trough SQUID12, an ethylene vinyl alcohol copolymers (EVOH) which exhibits many advantages over other embolic agents, due to its better devascularization rate and lower risk of systemic complications. Our data support the hypothesis that transoral surgery scenario should be significantly revised, as it could represent a valid treatment for tumors located in lower and prestyloyd portion of PPS. Moreover, SQUID12, a novel embolization agent, may be a very promising choice for PPS hyper vascularized tumors, ensuring higher devascularization rate, safer procedures and lower risk of systemic dispersion compared to traditional Contour treatment.

Keywords: Contour; EVOH; SQUID12; para-pharyngeal space; transoral surgery.

Figure 1

Para-pharyngeal space tumors clinical features. (A): main presenting symptoms and clinical signs. (B): different tumor types.

Figure 2

Parapharyngeal space anatomy. Yellow box: representation of pyramid shaped parapharyngeal space. 1: sagittal section view. 2: cross section view.

Figure 3

(A) 91 y.o. patient, treated for a pleomorphic adenoma of the deep parotid lobe (56 × 49 × 50 mm). (A–C): MRI t2-TSE ax; (D–F): Tumor excision/transoral approach).