Schwannomas of the parapharyngeal space are rare benign tumors arising from nerves located in the parapharyngeal space. Most of them occur as a mass behind the ascending ramus of the mandible, and bimanual palpation is important in ascertaining their exact location. The anatomy of the parapharyngeal space is described in detail. Treatment of these tumors is surgical through an external neck approach. A combined neurosurgical approach is indicated for tumors extending intracranially. Four cases of parapharyngeal schwannomas are added to the world literature (114 reported), with one extending intracranially through the jugular foramen.
In this study, influenza vaccination was associated with decreased mortality and influenza infections in community-dwelling elderly. Our results indicate that, in a season of mild influenza activity and good antigenic match between vaccine strains and circulating strains, influenza vaccination reduced mortality in the vaccinated population. Our data support an annual vaccination strategy for all community-dwelling elderly.
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