Tumores del espacio parafaríngeo. Nuestra experiencia-i.p.o. francisco gentil-lisboa

Resumen

Los tumores primarios del espacio parafaríngeo son poco frecuentes, representando el 0,5% de los tumores de cabeza y cuello. realizamos un estudio retrospectivo de 38 pacientes con este diagnóstico sometidos a intervención quirúrgica entre 1975 y 1998. de éstos, 26 eran de sexo femenino (68%) y 12 varones (32%). treinta y tres correspondieron a patología tumoral benigna (87%) y 5 malignos, siendo el adenoma pleomorfo el más frecuente (39%). el tratamiento fue quirúrgico en todos los casos, utilizándose un abordaje transcervical en 19 casos, cervical parotídeo en 5, transparotídeo en 7, transoral en 5, transmandibular en 2 y combinado transoral-transcervical en 1 caso. dentro de la patología benigna, se diagnosticó una recidiva correspondiente a un adenoma pleomorfo operado por vía transoral; en la patología maligna, la recidiva o exéresis parcial se verificó en 4 casos, correspondiendo la mortalidad a tres de éstos, tras exéresis incompleta del tumor

Abstract

Primary parapharyngeal space tumours are rare, representing only a 0.5% of head and neck neoplasms. the authors report a case series review of 38 patients with parapharyngeal tumours who underwent surgical excision between 1975 and 1998. twenty-six of them were female (68%) and twelve male (32%). thirty-three tumours (87%) were benign and five (13%) were malignant being the pleomorphic adenoma the most common neoplasm (39%). all patients were treated surgically: the trans-cervical approach was used in 19 cases, cervical-parotid in 5, the trans-parotid approach in 7 patients, transoral in 5, the cervical-parotid approach with mandibulectomy in 2 and the combined transoral-cervical approach in 1 case. out of the 33 patients with benign neoplasms, 1 (a pleomorphic adenoma treated through a transoral approach) had a recurrence. amongst the 5 with malignant disease, recurrence or persistent local tumour was seen in 4 cases; and of these, 3 with persistent local tumour after incomplete excision died