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Abstract：
Backgrounds/Objectives: Parotid gland tumors (PGTs) with parapharyngeal space (PPS) involvement have a specific clinical course and they can be a great challenge for surgeons, especially due to more difficult approaches and the risk of serious complications. The aim of this study is to present the characteristics of PGTs with PPS involvement. Methods: Retrospective, multicenter analysis of 1954 primary PGTs from 5 years (2017-2021) was performed. Comparative analysis was performed between groups with and without PPS involvement and included the following clinical and histopathological data: age, sex, place of residence, tumor size, FNAC result, percentage of malignant tumors, histological diagnosis, radicality of resection, and postoperative facial nerve (FN) dysfunction. Results: PPS involvement was found in 114 patients (5.83%). Secondary tumors affecting the deep lobe or the entire gland were predominant (46 and 60 cases, respectively). In a univariate analysis of tumors with and without PPS involvement, statistically significant differences were found in their size > 4 cm (12.97% vs. 37.72%), percentage of malignant tumors (7.12% vs. 17.55%), incidence of Warthin Tumors (WTs) (43.58% vs. 24.56%), percentage of R1 resection (5.53% vs. 12.50%), and rate of FN paresis (17.15% vs. 53.34%). Multivariate analysis showed that tumors with PPS involvement were statistically significantly characterized by larger size (tumors > 4 cm were 2.9 times more frequent), 2 times less frequent occurrence of WTs, and 1.6 times higher risk of FN paresis. Conclusion: PGTs with PPS involvement show certain clinical and histological differences and require more complex surgical accesses. Therefore, they cannot be treated as \"ordinary\" tumors occupying the deep lobe.
摘要：
背景/目的：腮腺肿瘤（PGT）与咽旁间隙（PPS）有一个特定的临床过程，他们可能是一个巨大的挑战，特别是由于更困难的方法和严重并发症的风险。本研究的目的是介绍具有PPS参与的PGT的特征。方法:回顾性,对5年(2017-2021年)的1954例原发性PGT进行了多中心分析。在有和无PPS受累的组间进行比较分析，包括以下临床和组织病理学数据：年龄，性别,居住地,肿瘤大小,FNAC结果，恶性肿瘤的百分比，组织学诊断,切除的激进性，术后面神经（FN）功能障碍。结果:114例(5.83%)患者出现PPS受累。以影响深叶或整个腺体的继发性肿瘤为主（46和60例，分别)。在有和没有PPS参与的肿瘤的单变量分析中，在它们的大小>4厘米(12.97%vs.37.72%），恶性肿瘤的百分比(7.12%vs.17.55%），Warthin肿瘤（WTs）的发病率（43.58%vs.24.56%），R1切除百分比(5.53%vs.12.50%)，和FN轻瘫率(17.15%vs.53.34%）。多因素分析显示，PPS受累的肿瘤具有较大的统计学特征（肿瘤>4cm的发生率为2.9倍），WTs发生频率较低的2倍，和1.6倍的FN轻瘫风险。结论：PGT伴PPS受累表现出一定的临床和组织学差异，需要更复杂的手术入路。因此,它们不能被视为占据深叶的“普通”肿瘤。
