Parapharyngeal Space Tumors: A Clinico-pathological Study

Hurtamina Khan, S. M. Tariq Rafi, Sameer Qureshi, Razzaq Dogar, Jawed Jamali

Abstract

Objective

To find out clinical presentation, radiological features, histopathological pattern, surgical treatment and outcome of parapharyngeal space (PPS) tumors.

Study design

Descriptive case series.

Place & Duration of study

Department of ENT/ Head and Neck Surgery, Jinnah Postgraduate Medical Centre (JPMC), Jinnah Sindh Medical University (JSMU) Karachi, from June 2010 to June 2018.

All patients with parapharyngeal tumors who were diagnosed during the study period were included. Symptoms and the stage of presentation were noted. Baseline investigations including CBC, urea/creatinine/electrolytes, viral markers, PT/ APTT, ESR and X- ray chest were done. Ultrasound neck, CT scan contrast and magnetic resonance imaging (MRI), were done to assess the extent of tumor and appropriate surgical approach for its removal. Fine needle aspiration cytology (FNAC) was done to evaluate the cytology.  Surgical excision of tumor under general anesthesia was carried out through different surgical approaches. Follow up was done at 3 months, 6 months and 1 year. Follow up was based on clinical examination and findings were recorded on a proforma. SPSS Version 16.0 was used for data entry and analysis.

Results

A total of 52 cases were managed during the study period. There were 29 (55.76%) males and 23 (44.24%) females. Mean age of the patients was 42 ± 6.48 year. There were 45 (86.5%) benign and 7 (13.4%) malignant tumors. The common presenting symptoms were neck swelling (n=32 - 61.5%), mass in oral cavity (n=14 - 26.9%) and dysphagia (n=6 - 11.5%). Transcervical approach was the most common approach (n=37 - 71.1%). Only 67.3% patients could be followed after surgery. In cases of transcervical and trans-mandibular approach the only complication occurred was marginal mandibular nerve palsy.

Conclusions

Parapharyngeal space tumors were difficult to diagnose and treat among head and neck tumors. Neck swelling was the most common symptom. Benign tumors found in majority of patients. Pleomorphic adenoma was the most common tumor in this series.

Key words

Parapharyngeal space tumors, Head and neck tumors, Nasopharynx tumors, Pleomorphic adenoma.