Otolaryngology: Open Access
Open Access

Abstract

Parapharyngeal space is a complex potential space situated on both sides of the upper neck and contains several vital neurovascular structures. Parapharyngeal tumors are relatively rare, less than 0.5% of head-neck neoplasms. Because of location in a critical space and heterogeneous histological variety, often they impose diagnostic dilemma. FNAC may be difficult and risky. Biopsy may not be possible. Although mostly benign, primary malignant tumors, metastatic lymphnodes, involvement from lymphoproliferative diseases and tumors extending from adjacent sites may also occur. This is a series of 173 such cases in seven years period (July 2008 to June 2014). Neck swellings, bulging of lateral pharyngeal wall medially and forward bulging of the soft-palate are common clinical features. Dysphagia, cranial nerve palsies (lower four) and dull earaches are occasionally present. Some sophisticated tools can be used to get an idea about the diagnosis like Imaging (CT, MRI, MRA, CT angiogram), CT guided FNAC, urinary VMA estimation, etc. Common surgical approaches are Trans-Cervical, Trans-Mandibular, Trans-Parotid and combination of above two or three. Per-oral approach for small tumors and skull base approaches for high-up tumors were also required. Cerebrovascular accident was the gravest complication of surgery. Temporary and permanent palsy of the cranial nerves were the commonest complications. Surgeons dealing with the PPS tumors must be well versed with the complex anatomy of the space, sufficient skill and experience of surgeries around carotid arteries and should have knowledge how to deal with the vascular accident.

Biography

Belayat Hossain Siddiquee is a Pioneer Head Neck Surgeon in Bangladesh. He has started his career as Head Neck Surgeon in 1992 after obtaining Fellowship in ORLHNS from Bangladesh. He is the Founder Chief of HNS Division, BSMMU, Founder President, Bangladesh Society of HN Surgeons, Governing Council Member, Asian Society Head-Neck Oncology (ASHNO), Councilor, IFHNOS, Country Coordinator, World Head-Neck Cancer Day and Editorial Board Member of Springer journal Oral Cancer.

Email: drbelayat@gmail.com