Introduction: Parapharyngeal space (PPS) is defined as a deep space, located around the upper pharynx, in the shape of an inverted pyramid. Primary tumours in this region are rare, accounting for 0.5% of head and neck neoplasms, and most are benign. The objective of this study is to propose a new study algorithm based on a systematic review and our experience.
Materials And Methods: A cross-sectional and analytical study was carried out through review of the clinical records of our hospital. Patients with tumours of the parapharyngeal space operated from January 2010 to December 2019 and a systematic review of Pubmed studies from the last 5 years were included. We considered clinical signs, diagnostic methods, presumptive diagnosis and histopathological findings. Statistical analysis was performed with STATA v.14 software.
Results: 53 of our cases and 1392 from the review were included. The clinical algorithm showed a sensitivity of 76.4% and a specificity of 96.3%, with an AUC of 0.57 for diagnosis.
Discussion: Complementary radiological examinations are essential in the topographic diagnosis of the tumour. Angio-MRI links the tissue of origin of the tumours and provides the highest diagnostic certainty. FNA has some disadvantages in PPS, but it is useful in some patients.
Conclusion: The proposed algorithm contributes to obtaining excellent results in the management of these tumours because it turned out to be effective in diagnosis, and this enables improved surgical planning.
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http://dx.doi.org/10.1016/j.otoeng.2020.11.007 | DOI Listing |
Ther Clin Risk Manag
December 2024
Department of Otolaryngology, Shenzhen Longgang Otolaryngology Hospital & Shenzhen Otolaryngology Research Institute, Shenzhen, People's Republic of China.
Objective: This study aims to summarize the clinical characteristics of skull base osteoradionecrosis (ORN) with the internal carotid artery (ICA) involvement and to distill the key surgical techniques that can enhance the protective measures for ICA.
Methods: We conducted a retrospective, observational study over a six-year period from February 2017 to May 2023. We included patients who were diagnosed with osteoradionecrosis with invasion of the internal carotid artery and collected their demographic information, pathology results, complication rates, ect.
Odontology
December 2024
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
In this study, we aimed to identify risk factors that predict the postoperative need for advanced or prolonged airway management in patients with severe odontogenic deep neck infections (DNIs). This retrospective case-control study included patients of both sexes aged ≥ 18 years who had undergone surgical drainage including debridement of necrotic tissues of odontogenic deep neck abscesses and necrotizing soft tissue infection under general anesthesia between April 2016 and September 2023 at a single center. The patients' characteristics, laboratory tests, and computed tomography (CT) findings were analyzed and compared between the difficult postoperative airway group, which required prolonged intubation or tracheostomy, and the short-term intubation group.
View Article and Find Full Text PDFEur Arch Otorhinolaryngol
December 2024
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, 1st Dongjiaominxiang, Dongcheng District, Beijing, 100730, China.
Purpose: A transoral surgical corridor can provide adequate exposure for extirpation of benign tumors arising from the parapharyngeal space (PPS). However, peri-operative complications following a transoral approach to the PPS have not been sufficiently described. This study retrospectively reviewed patients with PPS tumor extirpated via an endoscopic-assisted transoral approach, aiming to evaluate the safety of this approach and summarize the peri-operative complications.
View Article and Find Full Text PDFSurg Radiol Anat
December 2024
Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str., Goudi, Athens, 11527, Greece.
Background: The external carotid artery (ECA) branching pattern has been extensively studied in the current literature. However, its topographical variability has been barely reported. The aim of the current study was to assess the ECA in relationship with the styloid process (SP) and the mandible.
View Article and Find Full Text PDFRofo
December 2024
Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt Center of Radiology, Frankfurt am Main, Germany.
Diagnosis of lesions of the parapharyngeal space (PPS) often poses a diagnostic and therapeutic challenge due to its deep location. As a result of the topographical relationship to nearby neck spaces, a very precise differential diagnosis is possible based on imaging criteria. When in doubt, imaging-guided - usually CT-guided - biopsy and even drainage remain options.
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