Parapharyngeal Space Surgery With Endoscope-Assisted Transcervical and Transoral Approach

Objective: This study aims to evaluate outcomes of endoscope-assisted transcervical (EA-TC) and endoscope-assisted transoral (EA-TO) approaches in parapharyngeal space (PPS) surgery. Methods: This retrospective study included 30 patients with prestyloid PPS tumors who underwent surgery using EA-TC or EA-TO approaches between 2022 and 2024. Demographic data, tumor characteristics, operative time, hospital stay, complications, and follow-up outcomes were analyzed. Results: Sixteen patients (53.3%) were female, and 14 (46.7%) were male, with a mean age of 38.9±16.8 years. EA-TC was performed in 20 patients (66.7%) and EA-TO in 10 patients (33.3%). Mean operative time was significantly longer in EA-TC compared with EA-TO (94.3±17.5 versus 51.8±8.6 min, P <0.001), whereas length of hospital stay was shorter in EA-TC (median 1 versus 3 d, P <0.001). No cranial nerve injuries were observed. Minor complications in the EA-TC group included only first bite syndrome (10%). No tumor recurrence was observed in either group. Conclusion: EA-TC and EA-TO approaches are safe and effective minimally invasive techniques for the management of selected PPS tumors, providing good surgical exposure, low complication rates, and favorable cosmetic outcomes.