Abstract：
Surgery remains the mainstay treatment for parapharyngeal space (PPS) tumors. Given the rapid advance and increasing usage of endoscopic and robotic techniques, we aimed to investigate the surgical trends of PPS tumors in our institution and analyze their impact on patients\' treatment outcomes.
All patients who underwent surgical resection of PPS tumors from 2014 to 2021 at the Eye, Ear, Nose, and Throat Hospital of Fudan University were retrospectively reviewed. Student\'s t-test, Chi-square test, and multinomial logistic regression analyses were used to compare the surgical outcomes between groups.
Of the included 389 patients, the recipients of endoscopic surgery have largely increased in our center, with 17 of 134 cases (12.7%) in the group 2014-2017 and 187 of 255 cases (73.3%) in the group 2018-2021. The use of transoral and trans-nasal approaches increased in recent years (5.2% in 2014-2017 vs. 26.0% in 2018-2021), while that of trans-mandibular and lateral skull base approaches decreased (5.9% in 2014-2017 vs. 0.8% in 2018-2021). Decreased blood loss of operation and decreased risks of postoperative neurovascular complications were observed in the group 2018-2021. Similar findings were observed among patients receiving endoscopic surgery when compared with those receiving conventional surgery.
In our institution, the overall trends in the surgical management of PPS tumors moved towards minimally invasive approaches with the assistance of endoscopy or surgical robots. The two surgical techniques were feasible and safe, and to a great extent, contributed to the improved surgical outcomes we observed in recent years.
All patients who underwent surgical resection of PPS tumors from 2014 to 2021 at the Eye, Ear, Nose, and Throat Hospital of Fudan University were retrospectively reviewed. Student\'s t-test, Chi-square test, and multinomial logistic regression analyses were used to compare the surgical outcomes between groups.
Of the included 389 patients, the recipients of endoscopic surgery have largely increased in our center, with 17 of 134 cases (12.7%) in the group 2014-2017 and 187 of 255 cases (73.3%) in the group 2018-2021. The use of transoral and trans-nasal approaches increased in recent years (5.2% in 2014-2017 vs. 26.0% in 2018-2021), while that of trans-mandibular and lateral skull base approaches decreased (5.9% in 2014-2017 vs. 0.8% in 2018-2021). Decreased blood loss of operation and decreased risks of postoperative neurovascular complications were observed in the group 2018-2021. Similar findings were observed among patients receiving endoscopic surgery when compared with those receiving conventional surgery.
In our institution, the overall trends in the surgical management of PPS tumors moved towards minimally invasive approaches with the assistance of endoscopy or surgical robots. The two surgical techniques were feasible and safe, and to a great extent, contributed to the improved surgical outcomes we observed in recent years.
摘要：
目的：手术仍然是咽旁间隙（PPS）肿瘤的主要治疗方法。鉴于内窥镜和机器人技术的快速发展和越来越多的使用，我们旨在调查我院PPS肿瘤的手术趋势,并分析其对患者治疗结局的影响.
方法：2014年至2021年所有接受PPS肿瘤手术切除的患者，耳朵,鼻子,回顾性分析复旦大学附属喉部医院。学生t检验，卡方检验,和多项logistic回归分析用于比较组间的手术结局.
结果：在纳入的389例患者中，在我们中心，内窥镜手术的接受者大量增加，2014-2017年组134例中的17例（12.7%），2018-2021年组255例中的187例（73.3%）。近年来，经口和经鼻方法的使用有所增加（2014-2017年为5.2％，而2018-2021年为26.0%），而经下颌和侧颅底入路的入路下降(2014-2017年为5.9%，与2018-2021年为0.8%）。在2018-2021年的组中观察到手术失血减少和术后神经血管并发症的风险降低。与接受常规手术的患者相比，接受内窥镜手术的患者也观察到了类似的发现。
结论：在我们的机构中，在内窥镜或手术机器人的辅助下,PPS肿瘤的手术治疗总体趋势朝着微创方法发展.两种手术技术是可行和安全的，在很大程度上，有助于我们近年来观察到的手术结局改善.
方法：2014年至2021年所有接受PPS肿瘤手术切除的患者，耳朵,鼻子,回顾性分析复旦大学附属喉部医院。学生t检验，卡方检验,和多项logistic回归分析用于比较组间的手术结局.
结果：在纳入的389例患者中，在我们中心，内窥镜手术的接受者大量增加，2014-2017年组134例中的17例（12.7%），2018-2021年组255例中的187例（73.3%）。近年来，经口和经鼻方法的使用有所增加（2014-2017年为5.2％，而2018-2021年为26.0%），而经下颌和侧颅底入路的入路下降(2014-2017年为5.9%，与2018-2021年为0.8%）。在2018-2021年的组中观察到手术失血减少和术后神经血管并发症的风险降低。与接受常规手术的患者相比，接受内窥镜手术的患者也观察到了类似的发现。
结论：在我们的机构中，在内窥镜或手术机器人的辅助下,PPS肿瘤的手术治疗总体趋势朝着微创方法发展.两种手术技术是可行和安全的，在很大程度上，有助于我们近年来观察到的手术结局改善.
