[Parapharyngeal space neoplasms]

To study parapharyngeal space (PPS) neoplasms which are rarely seen clinically.

A retrospective review was made of 59 patients with PPS neoplasm operated on from 1986 to July, 1997 in our institution.

Neurogenic tumors were the most common neoplasms, which constituted about 60 percent in the primary parapharyngeal space neoplasms. High-resolution computed tomography or magnetic resonance imaging was essential for diagnosis and presurgical planning. The transcervical approach was the preferred procedure for 75% benign parapharyngeal tumors. Middle mandibulotomy was used in 3 cases, including 2 small tumors confined to the superior aspect of the PPS and 1 carotid body tumor which extended to the skull base. Lateral skull base approach was utilized for 1 schwannoma originating in the jugular foramen with extension into the PPS.

We believe that transoral approach can be used for small tumors and transparotid approach may be especially indicated for removal of deep lobe parotid tumors with extension to the PPS. Middle mandibulotomy is a safe and efficacious approach for the removal of special PPS neoplasms.