Diagnostic and Surgical Approaches of the Parapharyngeal Space Tumors

Tae, Kyung; Lee, Keun Young; Lee, Young Seok; Lee, Yong Seop; Jeong, Seung Won; Park, Chul Won

Abstract

BACKGROUND AND OBJECTIVES: Tumors originating in the parapharyngeal space are rare, accounting for about 0.5% of all head and neck tumors. The anatomic characteristics of the parapharyngeal space makes clinical examination of this area difficult and unreliable method for assessment of these tumor. This study was performed to evaluate the proper diagnostic and surgical approaches for the parapharyngeal space tumors with our experiences.
SUBJECTS AND METHOD
During the period from January 1998 to December 2006, 34 patients underwent surgery for parapharyngeal space tumors. We reviewed medical records and imaging study retrospectively.
RESULTS
82.4% (28/34) of the parapharyngeal space tumors were benign; 17.6% (6/34) were malignant. 41.2% (14/34) were of salivary glandular origin, 35.3% (12/34) were of neurogenic origin, and 23.5% (8/34) were of miscellaneous origin. 76.5% (26/34) of cases had been performed fine needle aspiration cytology (FNAC) before surgery. 14 of 19 patients (73.7%) who had a diagnostic sample had a correct or highly suggestive diagnostic finding. Most of the parapharyngeal space tumors were treated with transcervical (44.1%;15/34) or transparotid (44.1%; 15/34) approach, and transparotidcervical approach was performed in 4 patients (11.8%). All patients with salivary gland tumor were located in the prestyloid space, and most (92.9%) of them were treated with transparotid approach. Most patients (91.7%) with neurogenic tumor were located in the poststyloid space and treated with transcervical approach.
CONCLUSION
In our study, the origin and location of the parapharyngeal space tumors were correlated with surgical approaches (p<0.05). Preoperative FNAC showed high accuracy to diagnose the tumor in the parapharyngeal space.