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Anna Ivanova, Juris Tars and Valerija Groma


Introduction. Parapharyngeal space (PPS) tumors are rare neoplasms that are greatly varying both clinically and morphologically. Complete tumor removal from the PPS requires an integrated approach to resection of nervous and vascular trunks and hemorrhage control.

Aim of the Study. This study aimed evaluation of surgical interventions applied for PPS neoplasms along with revision of postoperative complications noticed conducting these surgeries.

Material and Methods. 32 PPS tumors removed during surgeries as well as associated biopsies performed at Riga East University Hospital Oncology Center of Latvia at the Department of Head and Neck Surgery from 01.01.2001 till 31.12.2006 were included in this study.

Results. The largest number of patients presented with benign salivary gland tumors 22 (68.7%), followed by malignant salivary gland neoplasms 5 (18.5%), neurogenic tumors 4 (12.5%), and miscellaneous tumors 1 (0.3%). Postoperative complications for malignant salivary gland surgeries occurred at the highest rate (42%), whereas, for benign - at the lowest (5%). Transcervical - submandibular, transparotid, and transoral approach was used in 56, 25, and 1% of surgeries, accordingly, whereas, mandibulotomy applied in 17%. “First bite syndrome” was noticed in 30% of the cases, cranial nerve palsies - in 20%, temporary, permanent facial nerve and accessorial nerve injury in 4, 1 and 15% of surgical interventions, accordingly. Vascular trunks damage occurred at 9%, and, mostly, for poststyloid lesions.

Conclusions. Heterogeneous PPS tumors show a wide spectrum of postoperative complications and require a selective approach for optimization of surgical intervention and treatment strategy.

Open access

Kalvis Pastars, Jānis Zariņš, Juris Tārs, Anna Ivanova and Andrejs Skaģers


Radial forearm flap is a gold standard for oral soft tissue defect reconstruction after tumour ablative surgery of oral cancer in advanced stages. The main disadvantage of this flap is donor site morbidity. The goal of our study was to show versatility of lateral arm flap in 34 cases with different oral defects that were reconstructed after tumour ablation, and to analyse complications and donor site morbidity. Thirty-four patients with advanced stage oral cancer (T3 and T4) underwent tumour ablation with or without suspicious lymph node removal and with immediate reconstruction of oral defect with lateral arm flap. Analysis of complications and donor sites morbidity was carried out. The Michigan Hand Outcome Questionnaire was used to evaluate functional and esthetical donor site outcome during at least one year follow up. Thirty-one patients had successful free flap surgery with uneventful post-surgery period. Flap loss due to vascularity problems was in one case (2.9%). The flap success rate was 97.1%. The donor site was closed primarily in all cases and healed uneventfully. The Michigan Hand Outcome Score was average 94.30%. The lateral arm is an excellent choice for oral reconstruction after ablative tumour surgery. It is versatile, safe and reliable for oral reconstruction with very good functional and aesthetical donor site outcome.