The Imaging Features Of The Tumors In The Parapharyngeal Space And Associated With The Choice Of Surgical Approaches

PurposeTo analyze the imaging characteristics of CT/MRI tumors in the parapharyngeal space and choose the appropriate surgical approach.Method25 patients among which 17 males and 8 females with parapharyngeal space tumors by pathological diagnosis in Otolaryngology Head and Neck Surgery of our hospital were analyzed retrospectively from 2010.1 to 2018.1.The age range of these patients is from 26 to 68 and the average is 45 years old.The course of disease is form 10 days to 3 years.In the preoperative examination,there are 21 cases with MRI,2 cases with CT and MRI,1 case with PET-CT and one imaging data is lost.We can offer some useful information for the choice of the surgical approaches by evaluating whether the tumor is from the prepharyngeal space or the postpharyngeal space by observing its size,location,shape,the relation with the belonoid and the parotid,the shift direction of the digastric muscle and the blood vessels in the neck,the signal of DWI in MRI,and the situation after enhancement.ResultsAmong these 25 cases,the statistic shows that it occurs more on young and middle ages,especilly from 30-50 years old.A total of 12 cases is in this age group accounting for 48%.However,these patients show different kinds of symptoms including 9 cases with paraesthesia pharynges(36%),4 cases with Pharyngeal or neck mass(16%),4 cases with hoarseness(16%),5 cases with snoring(20%),2 cases with pharyngalgia(8%),1 case with hearing loss(4%)..Two cases were misdiagnosed as the nasopharyngeal carcinoma in other hospitals(case 21,case 25).Here are our surgical approaches:23 cases with transoral approach:(10 of which were assisted by nasal endoscopy),2 cases combining transoral approach with neck incision approach.Pathology results show that all tumors are benign tumors.The postoperative routine pathology indicated that there are 16 cases of tumors deriving from the salivary gland(including 13 cases of pleomorphic adenoma and 3 cases of basalioma),7 cases of neurogenic tumors,1 case of cyst and 1 case of fibrosarcoma.Conclusion1.The pathological type of tumor in the parapharyngeal space is diverse and the imaging features of different kinds of tumor are different.2.Operative imaging features could offer better information for the choice of surgical approaches.