Giant Parapharyngeal Space Lipoma Extending to the Pterygoid Region (Anterior Skull Base)

Although lipoma is frequently seen in the head and neck region, but occurrence of the lipoma in the parapharyngeal space is rare. It is extremely rare for a parapharyngeal lipoma to extent to the pterygoid region (ie, anterior skull base). Management of giant parapharyngeal space lipoma with skull base extension and proximity to the vital neurovascular structures poses a challenge to surgeon. The authors report a patient with giant lipoma extending from the upper border of the clavicle to the pterygoid region. Complete excision was done using upper transverse cervical incision and pterygoid region was approached after removal of the ipsilateral submandibular gland. Surgery produced excellent cosmetic results with no functional impairment.