Differential diagnosis and surgical management of parapharyngeal masses: Review and an unusual illustrative case

Pedlar, J.; Ravindranathan, N

doi:10.1016/0030-4220(87)90250-7

Cited by 9 publications

(1 citation statement)

References 24 publications

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“…Bis an das Foramen jugulare reichende Tumoren erfordern manchmal die Abtragung der Mastoidspitze unter Transposition des N. facialis aus dem Fallopschen Kanal [14,20]. Bis an das Foramen jugulare reichende Tumoren erfordern manchmal die Abtragung der Mastoidspitze unter Transposition des N. facialis aus dem Fallopschen Kanal [14,20].…”

Section: Transzervikaler Zugangunclassified

Parapharyngeale Raumforderungen Differenzialdiagnostik anhand von Fallbeispielen

Weber

Tannapfel

Kösling

et al. 2002

HNO

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Section: Transzervikaler Zugangunclassified

Parapharyngeale Raumforderungen Differenzialdiagnostik anhand von Fallbeispielen

Weber

Tannapfel

Kösling

et al. 2002

HNO

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“Parapharyngeal space” tumors: A cytopathological study of 24 cases on fine‐needle aspiration

Oliai

Sheth

Burroughs

et al. 2004

Diagnostic Cytopathology

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The parapharyngeal space (PPS) is a well-defined anatomic zone of loose connective tissue lying deep to the tonsil and lateral to the pharynx. Neoplasms arising within the PPS are rare. We retrospectively reviewed 24 PPS fine-needle aspirations (FNAs) performed at The Johns Hopkins Hospital over the past 16 years (1987-2002). Patients presented with neck pain, dysphagia, and/or intraoral swelling of varying duration. Radiographic imaging disclosed PPS masses, varying in size from 2.5 to 8 cm. The most common clinicoradiographic suspicion was a nerve sheath tumor. Six cases had FNA performed using a 23-gauge needle via a transoral approach in the outpatient suite whereas the remainder were aspirated via a 22-gauge Franseen needle under CT guidance. Six of 24 cases (25%) were nondiagnostic due to lack of adequate cellular material. Of the 18 cases considered diagnostic, there were nine (50%) pleomorphic adenomas (PAs); three (17%) squamous-cell carcinomas (SCC); and one each of oncocytoma, adenocarcinoma, not otherwise specified (NOS), adenoid cystic carcinoma, lipoma, neurofibroma, and non-Hodgkin lymphoma, together comprising the remaining 33%. Four of the six cases deemed nondiagnostic (consisting predominantly of blood) on subsequent tissue follow-up revealed paraganglioma (two cases), SCC (one case), and schwannoma (one case). PPS is an uncommon target of an FNA procedure. PPS masses represent a heterogeneous group of neoplasms of which PA appears most common, representing 50% of our diagnostic cases. The rate of nondiagnostic FNA samples is moderately high due to excessive bleeding encountered in this location and other technical problems relating to adequately targeting the lesion in close vicinity of major neck vessels.

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Tumors and Surgery of the Parapharyngeal Space

1994

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The parapharyngeal space, an area of complex anatomic relationships, is involved in a wide variety of benign and malignant neoplasms. Because primary parapharyngeal space tumors are rare, it is difficult to obtain surgical experience in this region. This paper reviews the anatomy, presentation, evaluation, surgical approaches, and pathologic features and complications reported in managing patients with parapharyngeal space neoplasms. Two surgical procedures have been used by the author to treat 44 tumors in the parapharyngeal space. The cervical‐parotid approach was used in 35 patients, and the cervical‐parotid approach with midline mandibulotomy was used in 9 patients. Of the 44 tumors, 32 were benign lesions and 12 were malignant neoplasms. Forty tumors were primary parapharyngeal space tumors, and 4 cases represented isolated metastases to parapharyngeal nodes. Recurrent tumors accounted for 12 of the 44 cases. Discussion of the indications, surgical technique, and select points pertinent to using these two operative procedures is based on the operative experience gained from these 44 patients. The use of these two operations resulted in low morbidity and provided a safe, efficacious approach to the management of all parapharyngeal space neoplasms encountered.

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Differential diagnosis and surgical management of parapharyngeal masses: Review and an unusual illustrative case

Cited by 9 publications

References 24 publications

Parapharyngeale Raumforderungen Differenzialdiagnostik anhand von Fallbeispielen

Parapharyngeale Raumforderungen Differenzialdiagnostik anhand von Fallbeispielen

“Parapharyngeal space” tumors: A cytopathological study of 24 cases on fine‐needle aspiration

Tumors and Surgery of the Parapharyngeal Space

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