Cervical approach for prestyloid parapharyngeal pleomorphic adenoma resection

O Laccourreye; A-L Gaultier; F Haroun; H Mirghani

doi:10.1016/j.anorl.2024.03.005

Cervical approach for prestyloid parapharyngeal pleomorphic adenoma resection

Eur Ann Otorhinolaryngol Head Neck Dis. 2024 Mar 27:S1879-7296(24)00049-8. doi: 10.1016/j.anorl.2024.03.005. Online ahead of print.

Authors

O Laccourreye¹, A-L Gaultier², F Haroun³, H Mirghani³

Affiliations

¹ Service d'otorhinolaryngologie et de chirurgie cervicofaciale, HEGP, Université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France. Electronic address: ollivier.laccourreye@aphp.fr.
² Service de radiologie, HEGP, université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
³ Service d'otorhinolaryngologie et de chirurgie cervicofaciale, HEGP, Université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.

PMID: 38548560
DOI: 10.1016/j.anorl.2024.03.005

Abstract

Objective: To describe the key points of cervical resection for prestyloid parapharyngeal pleomorphic adenoma and to discuss the role of modern imaging.

Observation: 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.

Conclusion: 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.

Keywords: Cervical approach; Parapharyngeal space; Pleomorphic adenoma; Prestyloid compartment.