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Contemporary evaluation and management of parapharyngeal space neoplasms

Published online by Cambridge University Press:  10 April 2013

D W Eisele  and
J D Richmon
D W Eisele*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
J D Richmon
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
*
Address for correspondence: Professor D W Eisele, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N Caroline Street, Suite 6210, Baltimore, MD 21287, USA E-mail: deisele1@jhmi.edu
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Abstract

Objective:

This review summarises the contemporary, multidisciplinary approach to managing parapharyngeal space neoplasms.

Overview:

Parapharyngeal space neoplasms are uncommon head and neck tumours and are most often benign. Most tumours are of either salivary gland or neurogenic origin. Patients tend to be asymptomatic even when tumours reach large sizes. Patients may present with a mass in the pharynx or neck, although frequently the tumour is found incidentally on an imaging study. Due to the limitations of physical examination in this anatomical area, imaging studies are essential to the evaluation of parapharyngeal space neoplasms. Cytopathology may provide additional diagnostic information. Open biopsy is rarely necessary and can be hazardous. Treatment is primarily surgical, and various surgical approaches can be tailored for a given neoplasm. Recently, a trend toward observation of select patients with asymptomatic neurogenic tumours has been advocated.

Conclusion:

The evaluation and management of parapharyngeal space tumours is best done by a multidisciplinary team. Treatment should be individualised, and the risks and benefits of surgical intervention need to be carefully weighed. Complications are best avoided by careful surgical planning.

Keywords

NeoplasmsSalivary GlandsSchwannomaParagangliomaVagus NerveReview
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 6 , June 2013 , pp. 550 - 555
Copyright
Copyright © JLO (1984) Limited 2013 

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Footnotes

Professor D W Eisele is one of the JLO 2013 Visiting Professors

Presented at the Royal Society of Medicine Section of Laryngology and Rhinology, 3 May 2013, London, UK

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