Parapharyngeal Tumors

42.1

Prestyloid and Poststyloid Tumors

The parapharyngeal space is a potential space in the deep neck, shaped like an inverted pyramid. The fascia, running posteriorly from the styloid process to the tensor veli palatini muscle, divides the parapharyngeal space into the prestyloid and poststyloid compartments.

It is difficult to evaluate tumor presence until they grow to at least 2.5–3 cm. The most frequent symptom and sign is an intraoral swelling (50%) or a cervical mass (47%). Other symptoms can be otalgia, dysphagia, and dysphonia.

Most parapharyngeal tumors are primary tumors. Approximately 70 different histologic subtypes of parapharyngeal space tumors are reported as 80% benign. Salivary gland tumors and neurogenic tumors comprise approximately 45% and 40%, respectively. Nasopharyngeal carcinoma can extend into the parapharyngeal space. Malignant tumors can metastasize to lymph nodes of the parapharyngeal space, most commonly thyroid cancer.