A.CHAI1, M.Y.LIM1, H.LI1, W.Z.FU1, J.K.SIOW1, Y.J.GAN1
Tan Tock Seng Hospital1
Tumours of the buccal space are rare and hence present a management challenge. We present a side-by-side comparison of the four main surgical approaches to the buccal space, demonstrating factors that contribute to the choice of surgical approach, their pros and cons and respective treatment outcomes. Through this case series, we aim to offer a guide to surgical planning for buccal space tumours by proposing a novel management algorithm (DSRB Ref: 2020/00803).
Over the course of 10 years, we managed five buccal space lesions at our ENT department. A 5x6cm facial nerve schwanomma, 2x2cm pleomorphic adenoma and 1.5x1cm lymph node excised via the transoral approach; a 1.5×1.5cm high grade polymorphous adenocarcinoma excised via the extended parotidectomy approach; and a 4.5x4cm pleomorphic adenoma excised via the upper cheek flap approach.
All buccal space tumours were completely excised and showed no recurrence for a median follow-up period of 6.7 years. We found that the transoral and extended parotidectomy approaches are the principle surgical approaches, both of which essential for their respective clinical scenarios.
From our findings, we propose a novel management algorithm to determine the recommended surgical approach for these rare tumours.