Surgical approaches to tumors of the parapharyngeal space

The authors' experience with 58 patients with parapharyngeal tumors is presented. Forty-nine patients were operated on using an external approach. Mandibulotomy was required in fewer than 10 per cent of procedures. The main features of the operation include identification of the facial nerve in all cases, division of the posterior belly of the digastric muscle and styloid apparatus, and excision of the styloid process. No patient died, and morbidity was acceptable and confined to malignant or locally invasive tumors.