Endoscope-Assisted Transcervical Resection of Parapharyngeal Space Tumors

Monday, September 30, 2024

2:54 PM – 3:00 PM EDT

Location: MBCC, 208

Disclosure(s):

Kevin J. Contrera, MD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Molly E. Heft Neal, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Matthew E. Spector, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Endoscope-assisted approach for transoral resection of parapharyngeal space (PPS) tumors is a well-described technique. Here, we describe a novel technique for endoscopic-assisted transcervical approach for resection of PPS tumors that affords improved surgical access, visualization, and efficiency over traditional methods.

Methods: This was a single-institution, retrospective review of patients undergoing transcervical approach for resection of PPS tumors from 2013-2023. Patients undergoing combined transcervical-transparotid approach were excluded. Demographic, clinical (e.g., tumor laterality, size, pre- vs post-styloid location), operative (capsule rupture, OR time, EBL) data and postoperative outcomes (tumor histology, margin status, recurrence, and facial nerve weakness). Chi-square and student’s t-test were used to compare variables between those cases in which a zero-degree endoscope was utilized (endoscope-assisted; EA) for resection vs not (traditional). Statistical significance was defined as p ≤ 0.05.

Results: Our cohort included 77 patients (n = 40 EA, n = 37 traditional) with PPS tumors. There was no difference in age, sex, laterality, or pre- vs post-styloid location between groups. Additionally, tumor size was similar between groups (median 3.4 cm for EA vs 4 cm for traditional, p = 0.17). The EA approach was associated with significantly shorter operative times (median [range] 73 [33 – 270] minutes versus 112 (56 – 362) minutes, p < 0.01) and reduced rates of immediate post-operative marginal mandibular branch paresis (n = 5 [12.5 %] vs n = 16 [43.2 %], p < 0.01). No difference in negative margin rate (p = 0.58) or tumor recurrence (p = 0.51) was seen.

Conclusions: We describe a novel approach for endoscope-assisted transcervical approach for resection of PPS tumors associated with improved surgical access, visualization, and efficiency and reduced rates of immediate post-operative marginal mandibular branch paresis.

Presenting Author(s)

JS

Joshua D. Smith, MD

Resident
University of Pittsburgh Otolaryngology
Ann Arbor, MI, United States

Disclosure information not submitted.

Co-Author(s)

SS

Shaum S. Sridharan, MD

Associate Professor
Department of Otolaryngology, University of Pittsburgh Medical Center
Pittsburgh, PA, United States

Disclosure information not submitted.
KC

Kevin J. Contrera, MD, MPH

Assistant Professor
Department of Otolaryngology, University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Steven B. Chinn, MD

Assistant Professor of Otolaryngology-Head and Neck Surgery
University of Michigan Otolaryngology
Ann Arbor, MI, United States

Disclosure information not submitted.
Molly E. Heft Neal, MD

Assistant Professor
University of Michigan
Ann Arbor, MI, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

MS

Matthew E. Spector, MD

Professor
Department of Otolaryngology, University of Pittsburgh Medical Center
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.