1 parapharyngeal mass and its management software

Approximately 70% to 80% of tumors originating from the pps are benign. It is also a key anatomic landmark for localizing disease processes in the surrounding spaces of the neck. Tumors of the parapharyngeal space pps, a potential space lateral to the upper pharynx, are uncommon, comprising less than 1% of all head and neck. Summary management of parapharyngeal masses should consider morbidity of surgical resection versus the natural course of the disease. Parapharyngeal space mass laryngology jama otolaryngology. We present five cases of parapharyngeal abscess resulting from. The case presented here is a 22yearold woman who was referred to our clinic with complaints of painless neck mass, dysphagia and. Request permission export citation add to favorites track citation. Ct scan and mri are important diagnostic tools, theyhelp in. The parapharyngeal space pps is located in the suprahyoid neck between the.

The parapharyngeal space pps is a suprahyoid infracranial fascial space of the neck surrounded by pharynx, parotid space, highest nodal levels, prevertebral musculature, masticatory muscles, and. Medical definition of parapharyngeal space merriamwebster. Abstract objective the purpose of this study was to evaluate our experience with the diagnosis and management of tumors of the parapharyngeal space pps, with. Epidemiology a person of any age can develop a parapharyngea. Due to its characteristic location, this anomaly may be confused with unilateral tonsillitis, peritonsillar abscess or parapharyngeal neoplasm. Characteristics of reported cases of branchial cyst in the parapharyngeal space author age sex treatment magnotti, 1927 1 8 f excision guissani, 1928 2 25 m excision hoogland, 1951 3 69 m aspiration taylor and burwell, 1954 4 53 m aspiration and sclerosant injection 49 m aspiration 54 m aspiration and sclerosant injection mills, 1959 5 52 f. Shapewise, the parapharyngeal space resembles an inverted pyramid. All patients were treated by intravenous antibiotics and steroids for.

This retrospective study over a period of 7 years concerned 16 patients hospitalized in an ent and head and neck surgery department for parapharyngeal abscess. Fibroblastic osteosarcoma ill arising from c2 vertebral body exostosis. Surgical management of parapharyngeal space tumors. Castleman disease presenting as a parapharyngeal mass. The choice of surgical approach is dictated by the size of the tumor, its location, its relationship to the great vessels, and the suspicion of malignancy. The surgical access to parapharyngeal space tumours is limited and difficult. Approximately 50% of the tumours have a salivary origin, 20% are neurogenic and the remaining 30% are represented by tumours such as benign and malignant lymphoreticular lesions, metastatic lesions and carotid body tumours. Mapping the nerve fiber with an electromyographic emg system may help. Surgical access to parapharyngeal space tumours the. Magnetic resonance imaging mri was negative for intracerebral pathology, but revealed a 4.

The lesion caused loss of the fat plane between the parapharyngeal space and masticator space with subsequent inflammation of the pterygoid space. Peritonsillar abscess and tonsillitis may result in parapharyngeal abscess. Retropharyngeal mass laryngology jama otolaryngology. Since the introduction of antibiotics, the incidence of parapharyngeal abscess secondary to tonsillitis and peritonsillar abscess has decreased dramatically. The parapharyngeal pharyngomaxillary space is lateral to the superior pharyngeal. Parapharyngeal definition of parapharyngeal by medical. Dec 01, 20 intraoperatively, the mass was noted to be soft, friable, and well encapsulated, and it extended into the parapharyngeal space. May 01, 2020 the parapharyngeal space is called a potential space because of its ability to momentarily disappear. Parapharyngeal space an overview sciencedirect topics.

The parapharyngeal space pps is a welldefined anatomic region. Parapharyngeal space pps masses are uncommon, composing only 0. Pleomorphic adenoma concurrent in the parapharyngeal space and submandibular. Background head and neck parapharyngeal space tumors are rare. Parapharyngeal abscess radiology reference article. Most benign parapharyngeal space tumors can be removed surgically. The anatomic characteristics of the parapharyngeal space make clinical examination of this area a difficult and unreliable method for assessing these tumors. A rare synchronous occurrence of pleomorphic adenoma in the parapharyngeal space and submandibular gland of a 48yearold nigerian male is reported. Surgery was the main treatment 56% for parapharyngeal tumors. Total facial nerve palsy occurred in 2 cases, although 1 of these patients. It is worth mentioning that the primary tumors of the infratemporal fossa with ppsp extension are quite uncommon and mainly include the extracranial meningioma, fibrosarcoma, chondrosarcoma, lymphoma, angioma, and histiocytosis x.

To study the circumstances of diagnosis, predisposing factors, bacteriology and therapeutic management of parapharyngeal abscesses. The patient was administered general anesthesia and underwent surgery via a transcervical approach. It has clinical importance in otolaryngology due to parapharyngeal space tumours and parapharyngeal abscess developing in this area. In the first definition, familiar to most head and neck surgeons, the parapharyngeal space is divided into prestyloid and poststyloid retrostyloid compartments,10. Central to our understanding and appreciation of the parapharyngeal space, is the styloid process which divides the. Its borders include the nasopharynx and oropharynx medially, the masticator space anterolaterally, the deep lobe of the parotid gland posterolaterally, and the retropharyngeal space posteromedially fig. The importance of the parapharyngeal space also lies in its relationship with the other spaces of the neck 1. Cranial nerve function and neck range of motion were normal. Lateral and inferior to the parapharyngeal space is the carotid sheath, containing the internal carotid artery and cranial nerves ix, x and xi. Plain radiographs revealed a 3 cm spherical mass in the left parapharyngeal space fig.

The case presented here is a 22yearold woman who was referred to our clinic with complaints of. Management of parapharyngeal space tumors complete surgical excision is the mainstay of treatment for pps tumors. The importance of the parapharyngeal space also lies in its relationship with the other spaces of the neck. Surgery is the mainstay of treatment for pps tumors, and is performed. Histology of the mass and the left tonsil revealed epithelioid and sarcomatoid elements consistent with a biphasic tumor and a diagnosis of synovial sarcoma figure 3.

Sep 05, 2019 management of parapharyngeal space tumors complete surgical excision is the mainstay of treatment for pps tumors. Management of tumors arising in the parapharyngeal space. In the first definition, familiar to most head and neck surgeons, the parapharyngeal space is divided into prestyloid and poststyloid retrostyloid compartments 1 3,10. Surgical and ct examinations of 104 patients, each of whom presented with a parapharyngeal space mass, has resulted in the development of an updated ct protocol designed to provide a preoperative diagnosis. Kazi core messages parapharyngeal space is a deepseated fascial space associated with adjoining fascial spaces and the infratemporal fossa having a complex anatomy.

Surgical management of parapharyngeal space tumours. The masticator and parotid spaces are located laterally, the pharyngeal mucosal. These 12 parapharyngeal space tumours were treated with use of one of the various. The wellcircumscribed mass was t1isointense and t2hyperintense, contained regions of central low intensity, and exhibited peripheral enhancement on contrast administration. There was no demonstrable intraoral or pharyngeal swell ing. Pdf surgical management of parapharyngeal space tumours. In view of the above, a careful meticulous dissection is required via a safe approach like the. In the second definition, introduced by some radiologists, the prestyloid parapharygeal space is simply termed the parapharyngeal space, and the poststyloid. A diffuse, nontender swelling was present in the left preauricular region, but its margins were not palpable and it appeared simply as fullness of that side of the face. Neoplasms arising from the parapharyngeal space constitute 0. A case report of parapharyngeal space tumour remedy. Parapharyngeal abscess may cause lifethreatening complications. Surgical strategy is determined by location, size, and pathology. Trismus, drooling, dysphagia, and odynophagia also are observed commonly.

Tumors of parapharyngeal space iowa head and neck protocols. Various surgical approaches have been described for the management of these tumours. A thyroid tumor extending to the parapharyngeal space. Behind both the parapharyngeal space and carotid space lies the retropharyngeal space, and deep to this a potential space known as the danger.

Surgical and ct examinations of 104 patients, each of whom presented with a parapharyngeal space mass, has resulted in the development of an updated ct protocol designed to provide a preoperative d. Besides the pharynx, it is lateral to the medial pterygoid muscle, also known as the internal pterygoid muscle, which plays a role in chewing food. Ct scan head and neck lateral view showing soft tissue mass in the posterior pharyngeal wall. Parapharyngeal space definition of parapharyngeal space by. Parapharyngeal space lesions are diagnosed late with imaging and fineneedle aspiration cytology. Tumors in the parapharyngeal space pps are uncommon, 1 4 accounting for only 0. Jul 27, 2012 vagal schwann0ma in neck removed by bangladeshi ent surgeon dr.

Ct scan and mri are important diagnostic tools, theyhelp in determining the extent of. The pharyngeal mucosa of the left lateral pharyngeal wall was effaced owing to mass effect figure, a. This study compares endoscopeassisted transoral approach with the traditional approac hes. The parapharyngeal space is called a potential space because of its ability to momentarily disappear. Management of parapharyngealspace tumors request pdf. Endoscopeassisted transoral approach to parapharyngeal. Parapharyngeal space definition of parapharyngeal space. Parapharyngeal abscesses are deep neck abscesses involving the parapharyngeal space. Management of parapharyngeal neurogenic neoplasms generally consists of active surveillance due to perioperative risk for permanent. The parapharyngeal space also termed the lateral pharyngeal space, is a potential space in the head and the neck. One of the main reasons for interest in the parapharyngeal space is its critical location and anatomic relationships that allow it to act as a highway for the spread of infections and tumors from any of the areas that surround it to any of the other bordering spaces. Vagal schwannoma presented as parapharyngeal mass removed by bangladeshi ent surgeon dr,mahmudul hassan. Osteocartilaginous tumors in the parapharyngeal space. Ct head and neck anteroposterior view showing soft tissue mass arising from parapharyngeal space extending medially partially occluding airway.

Symptoms include fever, sore throat, odynophagia, and swelling in the neck down to the hyoid bone. Management of tumors of the parapharyngeal space cancer. In the second definition, introduced by some radiologists, the prestyloid parapharygeal space is simply termed the. Parapharyngeal space tumors are rare and account for 0. Parapharyngeal abscess merck manuals professional edition. Lipomas of the paraphayngeal space provide both diagnostic and therapeutic challenge. Parapharyngeal masses can represent a relevant differential diagnostic challenge for clinicians because of the variety of pathological entities that arise in the parapharyngeal space, and the anatomical and functional complexity of the region. Because most of these tumors are benign, mri allows the surgeon to select. Anatomical complexity and etiology med j malaysia vol 62 no 5 december 2007 415 medial displacement of the lateral pharyngeal wall and tonsil is a hallmark of a parapharyngeal space infection. The transcervical approach for parapharyngeal space. Parapharyngeal space pps tumours are very rare and account for only 0. Most parapharyngeal space masses benign, removed through. Menachem gross, ron eliashar, in orofacial pain and headache, 2008. Pleomorphic adenomas are the most common parapharyngeal space tumors.

Lecturer of surgical oncology national cancer institute,cairoeypt 20 2. On oropharyngeal examination, there was a pulsatile mass on right posterolateral pharyngeal wall, that is, behind posterior pillar with mild congestion of posterior pharyngeal wall. The parapharyngeal space may be divided into two compartments on the basis of its relationship to the styloid process or, more precisely, to the tensorvascularstyloid fascia fig. Salivary gland neoplasms benign to malignant ratio 3. The purpose of this study was to define preoperative criteria for enabling full extirpation of parapharyngeal space pleomorphic adenomas via the transcervical approach while minimizing functional and cosmetic morbidity. The masticator and parotid spaces are located laterally, the pharyngeal mucosal space is. A thyroid tumor extending to the parapharyngeal space bmc. Part 1, techniques and normal agerelated appearances lubdha m. Tumours of the parapharyngeal space are rare, accounting for less than 1% of all head and neck neoplasms. Management of tumors arising from the parapharyngeal space. Drug interaction checker pill identifier calculators formulary. We present five cases of parapharyngeal abscess resulting from tonsillitis and peritonsillar. Excision of tumors in the parapharyngeal space using an. Nov 15, 2007 to study the circumstances of diagnosis, predisposing factors, bacteriology and therapeutic management of parapharyngeal abscesses.

This is because it is a blind space enclosing important neurovascular structures with the tumour occasionally arising from the nerve sheath itself. Encountering a parapharyngeal mass with cystic appearance on imaging, one should rule out thyroid malignancy as differential diagnosis. Algorithm for management of neurovascular tumors of the parapharyngeal space carotid body tumors no neurological injury young old surgery surgery. It is a serious medical condition, potentially fatal, and requires prompt diagnosis and treatment. Most parapharyngeal space masses benign, removed through surgery. Ji hoon shin 1, ho kyu lee 1, sang yoon kim 2, choong gon choi 1 and dae chul suh 1. The parapharyngeal space is shaped like an inverted pyramid. The metastasis of papillary thyroid carcinoma to the parapharyngeal space is rare and discussed in the english literature before. It is extremely important to recognise such an entity before any oropharyngeal surgery, as inadvertent incision may lead to massive haemorrhage and even death. Also, malignant tumors from adjacent areas eg, the pharynx can extend into the. A new case of a branchial cyst of the parapharyngeal space. Concurrent pleomorphic adenoma in parapharyngeal space and.