Meningocele in the Parapharyngeal Space: A Case Report and Review of the Literature
Sijing Chen1,2, Zixuan Yang1, Jingwen Cao1,3
1Department of Otolaryngology-Head and Neck Surgery, The 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, China.
Abstract:
The parapharyngeal space has been described as an inverted pyramid shape with the base of the skull and the great cornu of the hyoid bone at the top. Tumors of the parapharyngeal space account for 0.5% of head and neck tumors and a wide range of tumor types can occur in this area, 80% of which are benign, the most common being pleomorphic adenomas of the salivary glands and neurogenic tumors. We present a 39-year-old woman who was hospitalized due to left-sided neck pain with a feeling of blockage in the left ear and hearing loss for 10 months. Imaging showed that the mass was not connected to the cranium and the patient underwent surgical resection via a transoral approach, where the contents of the mass were found to be cerebrospinal fluid, and meningocele in the parapharyngeal space is a rare occurrence. The patient presented mainly with painful symptoms, which were eventually relieved by nerve block therapy.
Insights
A rare case of parapharyngeal space meningocele caused neck pain and hearing loss. Surgical resection via a transoral approach successfully treated this unusual cerebrospinal fluid collection.
Area of Science:
- Neurosurgery
- Otolaryngology
- Head and Neck Surgery
Background:
- The parapharyngeal space, an inverted pyramid, harbors various tumors, predominantly benign (80%), such as pleomorphic adenomas and neurogenic tumors.
- Parapharyngeal space tumors represent a small fraction (0.5%) of all head and neck neoplasms.
Purpose of the Study:
- To report a rare case of parapharyngeal space meningocele presenting with neck pain and hearing loss.
- To highlight the diagnostic and therapeutic challenges associated with this uncommon condition.
Main Methods:
- A 39-year-old female patient presented with chronic left-sided neck pain, ear blockage, and hearing loss.
- Diagnostic imaging revealed a mass in the parapharyngeal space, not connected to the cranium.
- Surgical resection was performed using a transoral approach.
Main Results:
- The resected mass contained cerebrospinal fluid, confirming a diagnosis of parapharyngeal space meningocele.
- The patient's painful symptoms were significantly relieved following nerve block therapy post-surgery.
Conclusions:
- Parapharyngeal space meningocele is an exceedingly rare condition that can mimic common head and neck tumors.
- A transoral surgical approach can be effective for resection, and nerve block therapy can manage associated pain.
