Trans-cervical/transparotid-cervical approaches to large tumors in the parapharyngeal space

experiences of three tumors more than 7cm

Abstract

Either the transcervical approach (TCA) or transparotid-cervicarl approach (TPCA) without mandibulotomy is widely used for the removal of parapharyngeal space tumors(PPST). In the present study, we demonstrate three cases of large (>7cm) PPSTs, which well reflected the indications, limitations and pitfalls associated with these procedures. Case1 demonstrated that, when a tumor is benign and smoot even a large tumor(about10cm in size) can be removed satisfactorily by TCA/TPCA without a mandibulotomy. Case2 showed the limitations of TPCA without a mandibulotomy for a malignant tumor. In Case3, we encountered uncontrollable brisk bleeding from the pterygoid venous plexus, which is one of the fatal pitfall associated with TPCA for large recurrent tumors.