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Dabas SK, Menon NN, Ranjan R, Shukla H, Gurung B, Tiwari S, Bassan BB, Sinha A, Fernandes TB, Arora S, Verma A, Sharma A, Biswas S, Patnaik N, Tyagi T, Singal R. Transoral Robotic Surgery for a Rare Case of Venolymphatic Malformation in Parapharyngeal Space. Indian J Otolaryngol Head Neck Surg 2024; 76:2035-2041. [PMID: 38566704 PMCID: PMC10982192 DOI: 10.1007/s12070-023-04390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/18/2023] [Indexed: 04/04/2024] Open
Abstract
Venous malformations are low flow endothelial malformations with aberrant and ectatic venous channels. They are defects in vascular growth which causes functional and cosmetic impairment. Gradual growth in size of the lesion occurs due to venous congestion or thrombosis. Venous malformations in parapharyngeal space are a rare entity and are difficult to diagnose. Case Report. 13 year old boy presented with a history of hyposmia and progressive difficulty in breathing for a duration of 2.5 years. MRI face and neck with contrast showed a 4.5 × 4.3x3.6 cm lesion in the left parapharyngeal space. CT angiogram of brain and neck demonstrated a heterogeneously enhancing mass in the left parapharyngeal region. PET scan illustrated an ill-defined mass in the left pre styloid parapharyngeal space. Biopsy from the lesion showed features consistent with venolymphatic malformation. Flexible laryngoscopy showed a bulge over the left soft palate region with narrowing of nasopharyngeal lumen. Patient underwent transoral robotic surgery for complete excision of the mass. Post-operative period was uneventful. He has been on follow up for the past 1 year with no evidence of any residual or recurrent disease. Venolymphatic malformation is a rare lesion in the parapharyngeal space which is difficult to diagnose pre operatively. Surgical excision is the preferred modality of treatment for deep seated lesions in the parapharyngeal space. The advent of transoral robotic surgery have reduced the morbidity and improved clearance for such cases.
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Affiliation(s)
- Surendra K. Dabas
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Nandini N. Menon
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Reetesh Ranjan
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Himanshu Shukla
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Bikas Gurung
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Sukirti Tiwari
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Bharat Bhushan Bassan
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Ajit Sinha
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Trishala Bhadauria Fernandes
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Saurabh Arora
- Department of Nuclear Medicine, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Ankur Verma
- Department of Oncoanaesthesia, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Ashwani Sharma
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Shubhashish Biswas
- Department of Oncoanaesthesia, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Nivedita Patnaik
- Department of Histopathology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Tarun Tyagi
- Department of Oncoanaesthesia, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Rishu Singal
- Department of Radiodiagnosis, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
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Rose SE, Toong LY, Ghauth S, Ong DBL. Right Parapharyngeal Cavernous Hemangioma, A Rare Entity: Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2023:1455613231212597. [PMID: 37997797 DOI: 10.1177/01455613231212597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
Cavernous hemangioma is a noncancerous vascular growth that arises from different parts of the head and neck region. However, parapharyngeal space contributes a very small percentage for its occurrence. We present a case of right parapharyngeal cavernous hemangioma, a very rare clinical presentation. This is a 57-year-old female presented with throat discomfort for 3 months. Examination finding showed a soft, diffuse, and non-pulsating mass over the right upper jugulodigastric region. A contrasted computed topographic scan revealed multiple calcifications in right parapharyngeal space. T2-weighted magnetic resonance imaging showed right parapharyngeal space mass with high signal and multiple phleboliths and dynamic angiogram unremarkable. Surgical resection done via transcervical approach and histopathological report revealed cavernous hemangioma with calcified thrombi. In conclusion, surgical intervention is the mainstay treatment and transcervical approach which is adopted in this case is the commonest approach used in surgical resection of cavernous hemangioma.
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Affiliation(s)
- S Emelda Rose
- Department of Otorhinolaryngology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Liew Yew Toong
- Department of Otorhinolaryngology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sakina Ghauth
- Department of Otorhinolaryngology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Diana Bee-Lan Ong
- Department of Otorhinolaryngology, Universiti Malaya, Kuala Lumpur, Malaysia
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Miller JE, Sajed DP, Mendelsohn AH. Transoral Robotic Surgery for a Parapharyngeal Space Tumor. JAMA Otolaryngol Head Neck Surg 2023; 149:645-646. [PMID: 37200024 DOI: 10.1001/jamaoto.2023.0904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
A 71-year-old woman had a parapharyngeal space mass that was found on magnetic resonance imaging of the face. She experienced left jaw tightness, aural fullness, and facial discomfort. What is your diagnosis?
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Affiliation(s)
- Jessa E Miller
- Department of Head and Neck Surgery, University of California, Los Angeles
| | - Dipti P Sajed
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles
| | - Abie H Mendelsohn
- Department of Head and Neck Surgery, University of California, Los Angeles
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Bhuiyan MN, Medina-Inojosa JR, Croghan IT, Marcelin JR, Ghosh K, Bhagra A. Internal Medicine Physicians and Social media: Knowledge, Skills, and Attitudes. J Prim Care Community Health 2020; 11:2150132720969022. [PMID: 33131369 PMCID: PMC7607782 DOI: 10.1177/2150132720969022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective Increasing adoption of social media have revolutionized communications between individuals, groups, and organizations This research study was designed to assess the knowledge, skills, and attitudes of internal medicine physicians’ awareness and engagement with social media (sometimes referred to as #SoMe) within the digital landscape of healthcare delivery. Methods An audience-response survey focused on social media “Social media in Healthcare: Physician Survey,” was administered during the “A Systematic Approach to Medically Unexplained Symptoms” continuing medical education conference. The Conference took place between August 22, 2019 and August 24, 2019. Data was collected on August 23, 2019. A range of 103 (59.5%) to 112 (64.7%) of the total 173 attendees participated in this cross-sectional audience-response survey, depending on the questions answered. Results Most responders were between the ages of 35 and 65 years (79.6%) and female (60.2%). A majority of responders were aware of social media terminology (88.7%), and many had used it personally (46.7%), but only 12% knew how to use social media to search medical topics, 18% used it to network professionally and most (68.9%) had a distrust of social media when it came to the protection of their privacy or their patients’ privacy. Overall, about 29.6% indicated an interest in future continued medical education focused on social media (and 27.4% were neutral). Conclusions Approximately half of the responders used social media but far less engaged its platforms for professional use likely due to privacy related concerns. Distance from academic institutions, where professional social media use is more common likely, played a role in aversion. Awareness of social media’s role in healthcare has increased among physicians in practice, however their participation and knowledge of opportunities remains limited.
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Affiliation(s)
| | | | - Ivana T Croghan
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Karthik Ghosh
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Anjali Bhagra
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Kimura A, Seino Y, Yamashita T. Transoral endoscopic surgical approach to venous malformation of the parapharyngeal space. SAGE Open Med Case Rep 2020; 8:2050313X20938248. [PMID: 32670582 PMCID: PMC7339072 DOI: 10.1177/2050313x20938248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 06/06/2020] [Indexed: 11/22/2022] Open
Abstract
We encountered a rare case of venous malformation located in the parapharyngeal space.
The 65-year-old female patient did not have any symptoms, and the malformation was
discovered incidentally during a clinical survey. Examination of the oral cavity revealed
a mass in the left soft palate. Magnetic resonance imaging showed a well-defined mass in
the left parapharyngeal space. Fine needle aspiration cytology suggested no malignancy.
Four years after the first visit, she underwent surgery for diagnosis and treatment. We
safely removed the mass with a rigid videoendoscope trans-orally. No postoperative
complications arose, and she was discharged 7 days after the operation. Histopathological
examination identified cavernous hemangioma. Venous malformation (cavernous hemangioma) of
the parapharyngeal space is very rare, and few cases of removal under a transoral approach
using a rigid endoscope with a flexible tip have been reported. This approach is safe and
can be recommended for selected tumors of the parapharyngeal space.
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Affiliation(s)
- Akari Kimura
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yutomo Seino
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Taku Yamashita
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara, Japan
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