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J Neurol Surg B Skull Base 2021; 82(06): 675-681
DOI: 10.1055/s-0040-1715574
Original Article

Endoscopic Transoral Approach for Resection of Basal Cell Adenoma Arising in Parapharyngeal Space

Lifeng Li 
1   Department of Otolaryngology-Head & Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
,
Nyall R. London Jr
2   Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
3   Sinonasal and Skull Base Tumor Program, National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, Maryland, United States
,
Shuling Li   *
4   Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
,
Xiaohong Chen   *
1   Department of Otolaryngology-Head & Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
,
Ricardo L. Carrau
5   Department of Otolaryngology-Head & Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio, United States
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Abstract

Objectives The clinical and radiological characteristics of the basal cell adenoma (BCA) and its association with the internal carotid artery (ICA) in the parapharyngeal space (PPS), have not been sufficiently explored. This study aims to analyze the characteristics of patients with BCA arising in the PPS and to evaluate the feasibility of a total resection via an endoscopic transoral corridor.

Design and Main Outcome Measures The clinical, radiological, and histopathological characteristics of four patients with BCA arising in the PPS were retrospectively analyzed. The endoscopic transoral approach was performed for resection of BCA. Its technical nuances, perioperative comorbidities, and outcomes are introduced.

Results The clinical presentation, symptoms, and signs of patients with BCA are variable. The tumor was lateral to the ICA in two patients and anterior to the ICA in the remaining two. All four BCA were successfully removed en bloc (n = 3) or by piecemeal (n = 1) via an endoscopic transoral approach. The ICA was not injured, and no additional nerve damage, venous bleeding, postoperative infection, or salivary gland fistula were encountered in any of the four patients. Cystic degeneration is the predominant appearance of BCA on MRI; however, they are difficult to differentiate from other lesions arising in the PPS. No recurrence was detected at the time of the study analysis.

Conclusion BCA of the PPS could have variable relationships with the ICA. An endoscopic transoral approach can provide an adequate corridor for total resection of BCA in PPS with seemingly low morbidity.

Keywords

parapharyngeal space - retro-styloid space - basal cell adenoma - endoscopic - transoral - resection

* Authors contributed equally to this manuscript




Publication History

Received: 20 January 2019

Accepted: 11 June 2020

Article published online:
14 December 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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