Cervical approach for prestyloid parapharyngeal pleomorphic adenoma resection

• Published in: European annals of otorhinolaryngology, head and neck diseases Vol. 141; no. 5; pp. 292 - 296
• Main Authors: Laccourreye, O., Gaultier, A.-L., Haroun, F., Mirghani, H.
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.09.2024
• Subjects: Adenoma, Pleomorphic - surgery; Adult; Cervical approach; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Parapharyngeal space; Parapharyngeal Space - surgery; Pharyngeal Neoplasms - surgery; Pleomorphic adenoma; Postoperative Complications - etiology; Prestyloid compartment; Retrospective Studies; Salivary Gland Neoplasms - pathology; Salivary Gland Neoplasms - surgery; Prestyloid compartment; Cervical approach; Pleomorphic adenoma; Parapharyngeal space
• ISSN: 1879-7296; 1879-730X; 1879-730X
• DOI: 10.1016/j.anorl.2024.03.005

To describe the key points of cervical resection for prestyloid parapharyngeal pleomorphic adenoma and to discuss the role of modern imaging. Retrospective case series of 10 patients (4 women and 6 men, age 29–63 years) with prestyloid parapharyngeal pleomorphic adenoma with 2 to 8cm largest diameter on MRI, consecutively resected via a cervical approach between 2000 and 2020 in a French tertiary university referral care center. Seven patients had a minimum 10 years’ follow-up, and one was lost to follow-up before the fifth postoperative year. Peri- and postoperative complications comprised great auricular nerve transection without subsequent symptomatic neuroma (2 patients), associated transoral approach to free the upper pole of the adenoma (2 patients), capsule effraction (3 patients), and hematoma (1 patient). There were no cases of facial paresis or palsy, other cranial nerve impairment, trismus, auriculotemporal or first-bite syndrome. One of the three patients with capsule effraction showed local recurrence at month 17. In agreement with previous reports, the present case series confirmed the role of the cervical approach to resect prestyloid parapharyngeal pleomorphic adenoma, and hence the need to continue teaching it.