Radiological research methods in the diagnosis and treatment of patients with the parapharyngeal space tumors
Keywords:parapharyngeal space tumors, diffusion-weighted magnetic resonance imaging, perfusion magnetic resonance imaging, transoral surgical approach
The parapharyngeal space is a complex structure, being narrow and difficult for surgical approach. Surgical treatment is the main treatment for parapharyngeal space (PPS) tumors, it is performed on the basis of information obtained from imaging methods (computed tomography (CT) and magnetic resonance imaging (MRI)). Objective – to investigate the effectiveness of advanced visualization of radiological research methods in the diagnosis of the parapharyngeal space tumors in order to select the necessary tactics of surgical treatment. This retrospective study included 43 patients who underwent surgery for primary parapharyngeal space tumors from 2010 to 2021. 32 patients were treated in previous 10 years, 11 – patients who underwent examination and surgical treatment over the past 2 years with advanced methods of MRI and CT to select a safe surgical approach. Patients of the 2nd group underwent advanced MRI and CT studies in order to choose the correct method of surgical approach and prevent postoperative complications and recurrence. The histological conclusion in 90.1% of the operated patients confirmed the preliminary data of MRI perfusion regarding the probable histological structure of the neoplasm. Due to a comprehensive preoperative study, in 81.8% of patients in this group transoral approach was used. Our experience confirms the necessity for a thorough preoperative diagnostic procedure that should take advantage of imaging modalities (CT, MRI), especially new techniques (MRI-perfusion and diffusion weighted imaging).
Dimitrijevic MV, Jesic SD, Mikic AA, Arsovic NA, Tomanovic NR. Parapharyngeal space tumors: 61 case reviews. Int J Oral Maxillofac Surg. 2010;39:983-9. doi: https://doi.org/10.1016/j.ijom.2010.06.005
Horowitz G, Ben-Ari O, Wasserzug O, Weiz-man N, Yehuda M, Fliss DM. The transcervical approach for parapharyngeal space pleomorphic adenomas: Indi-cations and technique. PLoS One. 2014;9:e90210. doi: https://doi.org/10.1371/journal.pone.0090210
Chen H, Sun G, Tang E, Hu Q. Surgical treatment of primary parapharyngeal space tumors: a single-institution review of 28 cases. J Oral Maxillofac Surg. 2019;77(7):1520.e1-e16. doi: https://doi.org/10.1016/j.joms.2019.03.001
Razek A, Khalek AA, Sieza S, Germeen AA. Characterization of Parotid Tumors With Dynamic Suscep-tibility Contrast Perfusion-Weighted Magnetic Resonance Imaging and Diffusion-Weighted MR Imaging. Comput Assist Tomogr. 2017;41:131-6. doi: https://doi.org/10.1097/RCT.0000000000000486
Lien KH, Young CK, Chin SC, Liao CT, Huang SF. Parapharyngeal space tumors: a serial case study. J Int Med Res. 2019 Aug;47(8):4004-13. Epub 2019 Jul 29. PMID: 31353995; PMCID: PMC6726805. doi: https://doi.org/10.1177/0300060519862659
Fermi M, Serafini E, Ferri G, Alicandri-Ciufelli M, Presutti L, Mattioli F. Management of parapharyngeal space tumors with transparotid-transcervical approach: analysis of prognostic factors related with disease-control and functional outcomes. Eur Arch Otorhinolaryngol. 2022 May;279(5):2631-9. Epub 2021 Sep 16. PMID: 34529157.
Patadia S, Keshri A, Shah S, Shrivastava A. Benign Parapharyngeal Tumours: Surgical Intricacies by Transcervical Approach. Otolaryngology. 2016;6:219. doi: https://doi.org/10.4172/2161-119X.1000219
Arnason T, Hart RD, Taylor SM, Trites JR, Nas-ser JG, Bullock MJ. Diagnostic accuracy and safety of fine-needle aspiration biopsy of the parapharyngeal space. Diagn Cytopathol. 2012;40:118-23. doi: https://doi.org/10.1002/dc.21508
Jichi K, Murakami S. Surgical treatment of para-pharyngeal space tumors: A report of 29 cases. Oncol Lett. 2017;14(3):3249-54. doi: https://doi.org/10.3892/ol.2017.6480
Chen Z, Chen YL, Yu Q, Zhou SH, Bao YY, Shang DS, Ruan LX. Excision of tumors in the para-pharyngeal space using an endoscopically assisted transoral approach: a case series and literature review. J Int Med Res. 2019;47(3):1103-13. doi: https://doi.org/10.1177/0300060518816190
Vallabhaneni AC, Mandakulutur SG, Vallabhaneni S, Prabha A, Banavara RK. True parapharyngeal space tumors: case series from a teaching oncology center. Indian J Otolaryngol Head Neck Surg. 2017;69(2):225-9. doi: https://doi.org/10.1007/s12070-017-1099-0
Tryggvason G, Barnett A, Kim J, Soken H, Maley J, Hansen MR. Radiographic association of schwannomas with sensory ganglia. Otol Neurotol. 2012;33:1276-82. doi: https://doi.org/10.1097/MAO.0b013e318263d315
Bulut OC, Giger R, Alwagdani A, Aldabal N, Stenzinger A, Heimgartner S, et al. Primary neoplasms of the parapharyngeal space: diagnostic and therapeutic pearls and pitfalls. Eur Arch Otorhinolaryngol. 2021 Dec;278(12):4933-41. Epub 2021 Mar 19. PMID: 33740083; PMCID: PMC8553685. doi: https://doi.org/10.1007/s00405-021-06718-4
Sun F, Yan Y, Wei D, Li W, Cao S, Liu D, et al. Surgical management of primary parapharyngeal space tumors in 103 patients at a single institution. Acta Otolaryngol. 2018;138(1):85-89. doi: https://doi.org/10.1080/00016489.2017.1378433
Rzepakowska A, Osuch-Wójcikiewicz E, Żu-rek M, Durmaj A, Niemczyk K. Tumor, host and sur¬gery related factors predisposing to cranial nerve deficits after surgical treatment of parapharyngeal space tu¬mors. Eur Arch Otorhinolaryngol. 2021 Jun;278(6):1973-81. Epub 2020 Aug 10. doi: https://doi.org/10.1007/s00405-020-06261-8
López F, Suárez C, Vander Poorten V, Mäkitie A, Nixon IJ, Strojan P, et al. Contemporary management of primary parapharyngeal space tumors. Head Neck. 2019;41(2):522-35. doi: https://doi.org/10.1002/hed.25439
Pool CD, Goyal N. Parapharyngeal Space Tumors Treatment & Management. MedScape [internet]. 2017 Nov [cited 2022 Jun 12]. Avaliable from: https://emedicine.medscape.com/article/849385-overview
van Hees T, van Weert S, Witte B, et al. Tumors of the parapharyngeal space: the VU University Medical Center experience over a 20-year period. Eur Arch Otorhinolaryngol. 2018;275:967-72. doi: https://doi.org/10.1007/s00405-018-4891-x
Lajud SA, Aponte-Ortiz JA, Garraton M, et al. A novel combined transoral and transcervical surgical approach for recurrent metastatic medullary thyroid cancer to the parapharyngeal space. J Robotic Surg. 2019;14(1):233-6.
Meng L, Zhong Q, Fang J, et al. Early experience in endoscopic transoral resection for parapharyngeal space tumors. Ear Nose Throat J. 2018;97(4-5):E5-9. doi: https://doi.org/10.1177/0145561318097004-501
Larson AR, Ryan WR. Transoral Excision of Parapharyngeal Space Tumors. Otolaryngol Clin N Am. 2021;54:531-41. doi: https://doi.org/10.1016/j.otc.2021.03.001
Nornadiah R, Wah, Yap Bee. Power comparisons of Shapiro–Wilk, Kolmogorov–Smirnov, Lilliefors and Anderson–Darling tests. Journal of Statistical Modeling and Analytics. 2011;2(1):21-33. Retrieved 30 March 2017
How to Cite
Copyright (c) 2023 Medicni perspektivi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.