Endoscopic-Assisted Pterygomandibular Approach for Parapharyngeal Tumor Resection: A Case Series.

Abstract

Background: The endoscope-assisted pterygomandibular ligament approach for the resection of parapharyngeal space (PPS) tumors has been reported in a limited number of cases, with insufficiently detailed procedural descriptions.

Purpose: The study purpose was to report clinically relevant outcomes among patients who underwent endoscopy-assisted pterygomandibular ligament resection for PPS tumors.

Study design, setting, and sample: This study was a retrospective case series analyzing patients treated between January 2018 and July 2021 at the Department of Otolaryngology, Second Affiliated Hospital of Wenzhou Medical University. The sample consisted of patients who underwent endoscopy-assisted pterygomandibular ligament resection for PPS tumors. Patients with incomplete medical records or loss of follow-up were excluded.

Main outcome variable: The primary outcomes included successful tumor resection, intraoperative blood loss, operation duration, hospital stay, complications, recurrence, and follow-up duration.

Covariates: Demographic characteristics, tumor size, pathology, postoperative pain score were collected and analyzed.

Analyses: Data were summarized using descriptive statistics.

Results: The sample was composed of 9 patients (4 males, 5 females). The operation time ranged from 30 to 240 minutes, with operation blood loss between 5 and 200 mL. The average length of hospital stay was 8.45 days. The average pain score at the first postoperative day was 3.5. No complications, such as infection, bleeding, or nerve damage, were observed. No tumor recurrence was detected over a median follow-up of 53 months (interquartile range: 32.5).

Conclusion: The endoscope-assisted pterygomandibular ligament internal approach appears to be a good strategy for PPS tumor resection.