Endoscope‐Assisted Transcervical Resection of Parapharyngeal Space Tumors

Objective We describe a novel technique for endoscope‐assisted (EA) transcervical (TC) approach for resection of parapharyngeal space (PPS) tumors and compare perioperative outcomes of this approach to standard TC approaches. Study Design Retrospective chart review. Setting Single tertiary care center. Methods This was a single‐institution, retrospective analysis of all patients undergoing TC approach for resection of PPS tumors over a 10‐year period. We describe unique advantages of our surgical approach utilizing a 0° endoscope for improved surgical access, visualization, and efficiency. χ 2 and Student's t test were used to compare perioperative outcomes between cases in which an endoscope was utilized EA for resection versus standard TC approach. Results Our cohort included 77 patients (n = 40 EA, n = 37 TC). There was no difference in patient age, sex, tumor laterality, tumor size, or tumor location between groups. The EA approach was associated with significantly shorter operative times (median [range] for EA 73 [33‐270] minutes vs TC 112 [56‐362] minutes, P < .01) and reduced rates of immediate postoperative marginal mandibular nerve paresis (EA: n = 5 [12.5%] vs TC: n = 16 [43.2%], P < 0.01). Conclusion EA TC approach for resection of PPS tumors offers improved surgical access and is associated with reduced surgical time and rates of marginal mandibular nerve paresis compared to standard transcervical approaches.