Imaging of the parapharyngeal space

The parapharyngeal space is a deep space of the neck, always well visible on CT and MR imaging of the head and neck; in normal circumstances, this space should look symmetrical. The parapharyngeal space is often subdivided in compartments; such subdivision is helpful when considering the site of origin of a parapharyngeal space mass. Several concepts of compartmentalization of this space exist, sometimes leading to confusion; not the names but the anatomy is important to know. This manuscript reviews shortly the anatomy of the parapharyngeal space, the use of modern cross-sectional imaging methods in the evaluation of this region, and focuses somewhat more on imaging of primary parapharyngeal lesions.