Endoscopic-Assisted Transoral Approach to Parapharyngeal Space Tumours

Introduction Parapharyngeal space tumours are rare, mostly benign and present few symptoms, being difficult to diagnose it early. CT scan and MR are necessary for topographical diagnosis. Surgical resection is the best possible treatment option, but the approach remains a challenge, as there are several vital elements contained in the parapharyngeal space and, thus, adequate visualization is needed. Materials and Method Different surgical approaches have been described: transcervical-submandibular, transparotid, transmandibular, transoral and combined approach. Transoral approach is the most controversial one due to cited limited exposure which can lead to neurovascular injury or incomplete removal of the lesion. It is seldom performed and only for small, extra-parotid and non-vascular tumours of the parapharyngeal space. Wide access to endoscopic equipment in IFACF-ORL allowed us to perform medium to large benign parapharyngeal tumour resection with a transoral approach. Results and Conclusion The use of endoscopic assistance to transoral approach provided us direct and magnified visualization of the parapharyngeal space, reducing tissue damage, ensuring adequate hemostasis (which lead to less amount of bleeding) and also confirming complete resection prior to closure. In addition, compared to transcervical approach, transoral approachshortened hospitalization time and improved cosmetic appearance. Benign parapharyngeal space tumours not involving the critical structures in parapharyngeal space can be completely resected by an endoscopic-assisted transoral approach with good functional and cosmetic outcome.