Imaging description

The parapharyngeal space (PPS) is the central space of the suprahyoid neck, which is in close relationship with multiple other neck spaces. It extends as an inverted pyramid from the base of the skull down to the junction of the posterior belly of the digastric muscle and the hyoid bone. Apart from fat, it contains only vessels, and no other content such as mucosa, muscle, lymph nodes, or bones, although ectopic minor salivary glands can occur in this space [1].

PPS tumors are rare, accounting for 0.5% of all head and neck neoplasms. However, with its conspicuity on CT and MRI, the PPS serves as an important landmark to identify the space of origin of a mass within the suprahyoid neck [2]. Between 70% and 80% of intrinsic lesions within the PPS are benign in nature, with salivary gland neoplasm being the commonest, accounting for about 50% of the benign masses [3]. This is followed by neurogenic tumors and paraganglioma, in descending order [4]. The commonest malignant neoplasm within the PPS is mucoepidermoid carcinoma arising from salivary tissue.