A safe transoral surgical approach to parapharyngeal tumor arising from deep lobe of parotid gland.

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A safe transoral surgical approach to parapharyngeal tumor arising from deep lobe of parotid gland.

SAGE Open Med Case Rep. 2016;4:2050313X16682131

Authors: Casale M, Capuano F, Sabatino L, Pace A, Oliveto G, Vella P, Moffa A, Salvinelli F

Abstract
The management of parapharyngeal tumor is surgical, but the approach remains a challenge. Attention should be paid to avoidance intra-operative bleeding or cranial nerves damage. We report a case of a 67-year-old male complaining of left-ear fullness. A submucosal mass arising from the lateral wall of oropharynx on the left side was observed. Magnetic resonance imaging detected a mass arising from the parotid gland, in particular from the deep lobe, and a fine needle biopsy was compatible with "Warthin tumor." We performed a mini-invasive transoral approach under magnification, previous isolation of homolateral vessels. The decision on which surgical approach to be used is determined by site, size vascularity, and histology of the tumor. A literature review of the main surgical approaches was performed. We performed a combined transoral dissection under magnification with cervicotomic exposure of the neck vascular bundle allowing to dissect the tumor and manage any intra-operative complications.

PMID: 28228953 [PubMed - in process]

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