Abstract: PURPOSE: To evaluate the outcome of endoscopy-assisted transoral(ETO) approach for resection of parapharyngeal space tumors compared to endoscopy-assisted transcervical minimal incision plus osteotomy of the vertical ramus outside the mandibular foramen approach(ETC+MO). METHODS: Twenty-three consecutive patients (15 males, 8 females) who underwent resection of large parapharyngeal space tumors via ETO approach or ETC+MO approach were analyzed retrospectively. RESULTS: The tumors in ETO group were benign; there were 2 patients with adenoid cystic carcinoma and 1 patient with recurrent pleomorphic adenoma in ETC+MO group. All tumors were removed completely without rupture. No major complications developed in any patient. Temporary facial paresis occurred in 1 patient in the ETC+MO group, which resolved spontaneously within 8 weeks. The cosmetic effects of all patients in ETO groups and 10 patients in ETC+MO groups were excellent. Patients were followed up for 7-26 months, no recurrence was encountered. CONCLUSIONS: ETO and ETC+MO approach in resection of large parapharyngeal space tumors are feasible and safe, which can achieve excellent aesthetic and functional results. ETO approach can shorten hospitalized time and avoid the risk of marginal mandibular nerve injury and ETC+MO approach may be used in resection of malignant or recurrent parapharyngeal space tumors.

Key words: Endoscopy, Parapharyngeal space, Neoplasms, Transoral approach, Transcervical approach, Mandibular osteotomy