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<p>To analyze the clinical characteristics and surgical management of parapharyngeal space (PPS) neoplasms and to evaluate a radiologic, cranio-caudal classification system for guiding surgical approach.&#xa0;Sixty-three patients with PPS tumors treated between 2015 and 2022 were reviewed. Tumors originating within the PPS or extending into the PPS from adjacent sites were included; metastatic lesions were excluded. Tumors were categorized as high or low based on cranio-caudal radiologic location. Surgical approaches included transcervical (TC), transparotid-transcervical (TP+TC), transcervical with mandibulotomy, and infratemporal fossa (ITF) approaches. Surgical approach selection, histopathology, and outcomes were analysed.&#xa0;Fifty-eight tumors (92.1%) were benign and five (7.9%) were malignant. The TC approach was employed in 38 patients (65.5%), TP+TC in 5 (7.9%), TC with mandibulotomy in 12 (20.6%), and ITF in 3 (5.1%). Cranio-caudal tumor location reliably predicted the surgical approach required and enabled safe resection with appropriate exposure across tumor subtypes.&#xa0;A cranio-caudal radiologic classification of PPS tumors provides a pragmatic and reproducible framework for selecting surgical access and may offer superior operative planning compared with the traditional prestyloid–poststyloid paradigm. Adoption of this approach may optimize exposure while minimizing morbidity in PPS tumor surgery.</p>

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A cranio-caudal radiologic approach to surgical management of parapharyngeal space tumors: a 7-year experience

  • 期刊论文

  • 发表日期：

    2026年3月28日

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  • Aiswarya Vaidyanathan,
  • Abhishek Budharapu,
  • Umanath Karopadi Nayak,
  • Rahul Buggaveeti,
  • Ashwini Munnangi,
  • Ankita Kushwaha,
  • Susan Daisy Cris

摘要

To analyze the clinical characteristics and surgical management of parapharyngeal space (PPS) neoplasms and to evaluate a radiologic, cranio-caudal classification system for guiding surgical approach. Sixty-three patients with PPS tumors treated between 2015 and 2022 were reviewed. Tumors originating within the PPS or extending into the PPS from adjacent sites were included; metastatic lesions were excluded. Tumors were categorized as high or low based on cranio-caudal radiologic location. Surgical approaches included transcervical (TC), transparotid-transcervical (TP+TC), transcervical with mandibulotomy, and infratemporal fossa (ITF) approaches. Surgical approach selection, histopathology, and outcomes were analysed. Fifty-eight tumors (92.1%) were benign and five (7.9%) were malignant. The TC approach was employed in 38 patients (65.5%), TP+TC in 5 (7.9%), TC with mandibulotomy in 12 (20.6%), and ITF in 3 (5.1%). Cranio-caudal tumor location reliably predicted the surgical approach required and enabled safe resection with appropriate exposure across tumor subtypes. A cranio-caudal radiologic classification of PPS tumors provides a pragmatic and reproducible framework for selecting surgical access and may offer superior operative planning compared with the traditional prestyloid–poststyloid paradigm. Adoption of this approach may optimize exposure while minimizing morbidity in PPS tumor surgery.