Resection of macrosis benign parapharyngeal neoplasms via oral approach

OBJECTIVE: To explore investigate the feasibility of transoral removal of macrosis benign neoplasms in parapharyngeal space. METHODS: Sixteen patients with well-defined macrosis benign parapharyngeal space tumors treated by surgery from January 2005 to December 2012 were enrolled in this study. All patients were assessed by CT scan, MRI and CT angiography before surgery. Surgery for the tumors with complete peplos, locating at medial side of carotid and accessible from the oropharynx was completed with the assistance of endoscope, bipolar electrocoagulation or radiofrequency ablation system. RESULTS: All neoplasms were removed by transoral approach. Tracheotomy was performed in 4 cases. All patients were treated successfully with good postoperative recovery and no significant complications. Postoperative pathological examination showed there were 9 cases of pleomorphic adenoma, 5 cases of neurilemmoma and 2 cases of neurofibroma. By the follows-up of 1-8 years (median 31 months), among 16 cases only one case of neurofibroma recurred. CONCLUSION: The transoral removal of macrosis benign neoplasms in parapharyngeal space is safe, manimally invasive and feasible in selected cases, with a high local control rate and a low surgical complication rate.