Abordaje trans-oral asistido por endoscopio para tumores del espacio parafaríngeo: Reporte de Casos

Abstract

Introduction: Tumors of the parapharyngeal space represent a surgical challenge due to their relationship with critical neurovascular structures. Trans-oral approaches have been described being still controversial. Objective: To describe our experience in parapharyngeal tumor resection via trans-oral approach. Materials and Methods: Report of 2 clinical cases. Results: Two cases of patients with tumors of the parapharyngeal space are reported, with clinical symptoms and imaging suggestive of pleomorphic adenoma, reporting our surgical technique assisted with endoscopes. Both patients developed initial post-treatment trismus, which subsided completely. None of them presented cranial nerve damage or post-surgical bleeding. Discussion: The approach to parapharyngeal space tumors is challenging, the trans-oral approach being controversial, however with the advent of new technologies, endoscopes and robotic surgery, its indication has expanded. The use of the trans-oral approach assisted with endoscopes has been shown to present a lower risk of bleeding, operative time and hospital stay compared to open approaches, however, the evidence supporting it is of low quality. Even though more evidence is still needed it is a safe approach in selected patients.