Palatal Presentation of Para-Pharyngeal Mass

Para-pharyngeal space tumors showed a varied presentation and through a great challenge to the surgeon in respect to pre-operative evaluation as well as surgical approach. Para-pharyngeal space (PPS) is an inverted cone-shaped potential space that extends from the hyoid bone to the base of the skull.It is filled with fat and areolar tissue lie laterally on either sides of pharynx; and is bounded and subdivided by various condensations of fascia1 . Tumors, although rare less than1% of head neck neoplasm can arise from any structures of this space. Mostly they are benign70-80% and 20-30% are malignant. Salivary gland tumor, particularly deep lobe parotid constitutesmore than 80%2,3. Imaging studies are invaluable to define the site of origin, extension, relationship to the great vessels of the neck and other neurovascular structures4 . Surgery is the mainstay of treatment. Several approaches have been discussed in the text books. We present a case of a huge parapharyngeal space tumor that was excised completely through trans-cervical approach without any morbidly

Endoscope-Assisted Parapharyngeal Space Abscess Drainage

Background and Objectives Parapharyngeal space abscess (PPSA) may cause severe complications such as, airway obstruction, jugular thrombophlebitis, and mediastinitis unless early diagnosed and properly treated. Transoral drainage is known to reduce morbidity and hospital stays compared to the external drainage. The aim of this study is to assess the effect of endoscope when draining of PPSA via transoral approach.Subjects and Method We retrospectively reviewed charts of patients who were diagnosed with PPSA and treated surgically between February 2013 and September 2018. We included in the study 39 patients who underwent incisional drainage via transoral approach. Pateints were excluded had they undergo drainage via external approach or who treated with medication alone or operated for parapharyngeal space tumor. Thirty-nine patients were classified into two groups according to whether an endoscope was used or not when draining PPSA. We compared the hospital stays, estimated blood loss (EBL), operating time, revision rate, depth of abscess, and postoperative complications between two groups.Results Of the 39 patients [22 males (M), 17 females (F)], 13 patients (M:F=7:6) were classified as an endoscope group (EG) and 26 (M:F=15:9) as without endoscope group (WEG). The mean hospital stays of the EG and WEG were 7.6±4.6 and 9.8±4.8 days, respectively (<i>p</i>=0.188); the mean EBL of the EG and WEG were 222.2 and 254.0 mL, respectively (<i>p</i>=0.595); the mean operating time of the EG and WEG were 40.0±22.5 and 35.4±14.5 minutes, respectively (<i>p</i>= 0.457); the mean depth of PPSA of the EG and WEG were 4.5±0.9 and 4.0±0.7 c-spine level, respectively (<i>p</i>=0.043), and the revision cases of the EG and WEG were 1 and 2, respectively (<i>p</i>=1.000).Conclusion Endoscopes enabled the draining of PPSA to sit more deeply in the neck compared without it.

Clinicopathological Study of Parapharyngeal Space Tumor

Objective: To see the mode of presentation, diagnosis and management of parapharyngeal space tumours. Study design: Cross sectional study. Setting: Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Methods: The condition being relatively rare, it was difficult to find good number of fresh cases. We have studied all cases of parapharyngeal space tumour attending in the Bangabandhu Sheikh Mujib Medical University from January 2010 to March 2011. Result: Parapharyngeal space tumours are rare head and neck neoplasms.The third decade of life showed greatest incidence. The main presenting complaint’s were painless neck swelling (73%). The highest number of pathology were attached to the deep lobe of parotid gland (pleomorphic adenoma-27%) and then neurofibroma (20%). Of all cases 77% were benign. Their accurate diagnosis and management is challenging. Bangladesh J Otorhinolaryngol; April 2017; 23(1): 41-46