Access to parapharyngeal space vula university of cape town. Tumors of the parapharyngeal space pps, a potential space lateral to the upper pharynx, are uncommon, comprising less than 1% of all head and neck neoplasms. Pdf role of imaging in the diagnosis of parapharyngeal space. The parapharyngeal space is divided into two compartments by a fascia, which extends from the styloid process to the tensor veli. The case presented here is a 22yearold woman who was referred to our clinic with complaints of painless neck mass, dysphagia and. Parapharyngeal abscess radiology reference article. There is already an article for retropharyngeal space. The parapharyngeal space also termed the lateral pharyngeal space, is a potential space in the head and the neck. Pdf surgical treatment results of parapharyngeal space tumors. The anatomical location of the parapharyngeal space is rather unique.
A fascial layer was found extending from the medial pterygoid muscle to the skull base separating the masticator from the parapharyngeal space. Solitary fibrous tumor of the parapharyngeal space. To clearly define the anatomy of the prestyloid parapharyngeal space pps. Salivary gland neoplasms benign to malignant ratio 3. Trismus, drooling, dysphagia, and odynophagia also are. The styloid process divides the pps into an anterior or prestyloid compartment and a neurovascular or poststyloid compartment. The medial and lateral pterygoid plates were removed.
Separation of the masticator space from the parapharyngeal space. It consists largely of fat, neurovascular structures, and, in some definitions, the retromandibular part of the deep lobe of the parotid gland. It is a serious medical condition, potentially fatal, and requires prompt diagnosis and treatment. To demonstrate diagnostic approach of pps lesions by using ct and mr techniques. To describe novel techniques for imaging fatcontaining lesions of the pps, such as ideal mri. Parapharyngeal space synonyms, parapharyngeal space. To describe the imaging features of a variety of disease processes that may occur in the pps.
The anatomy of the parapharyngeal space is complex and critical. The parapharyngeal space, also known as the prestyloid parapharyngeal space, is a deep compartment of the head and neck around which most other suprahyoid fascial spaces are arranged. I believe it is the same, but it been some time since i had anatomy of the neck. Kazi core messages parapharyngeal space is a deepseated fascial space associated with adjoining fascial spaces and the infratemporal fossa having a complex anatomy. Trismus, drooling, dysphagia, and odynophagia also are observed commonly. Background the pps is defined as the deepest space in the neck and it consists of the pre. The displacement patterns of pps fat that are essential for accurate diagnosis and appropriate treatment of pathology arising in this region.
Contents fat main component trigeminal nerve cn v internal maxillary artery ascending pharyngeal artery. The separation of the masticator and parapharyngeal spaces is somewhat ambiguous. The tumor was a wellcircumscribed solid mass with a lobulated contour. The roof of the parapharyngeal space pps is poorly defined. Any information contained in this pdf file is automatically generated from digital. Parapharyngeal space article about parapharyngeal space by. Figure 3 postsurgical mri gadolinium contrastenhanced t2weighted coronal and axial mri images demonstrate a residual t2 hypointense, enhancing soft tissue mass involving the anterior left maxillary sinus, premaxillary soft tissues, and extending superiorly into. Parapharyngeal space synonyms, parapharyngeal space antonyms. Infections arise from foci in the mandibular teeth, tonsils, parotid gland, deep cervical lymph nodes, middle ear, or sinuses. The tensor veli palatini fascia did not contribute to the posterior marginal fascia.
Combines with buccopharyngeal fascia at level of t1t2. The metastasis of papillary thyroid carcinoma to the parapharyngeal space is rare and discussed in the english literature before. Mr imaging findings ae kyung jeong, ho kyu lee, sang yoon kim, and kyungja cho summary. Retropharyngeal space an overview sciencedirect topics. Bs buccal space, ica internal carotid artery, ijv internal jugular vein, ms masticator space, pms pharyngeal mucosal space, pps parapharyngeal space, ps parotid space, pvs prevertebral space, rps retropharyngeal space, sms submandibular space, t torus tubarius. Parapharyngeal abscess may cause lifethreatening complications. Imaging of parapharyngeal space lesions focus on the prestyloid compartment ji hoon shin 1, ho kyu lee 1, sang yoon kim 2, choong gon choi 1 and dae chul suh 1. Apr 02, 2017 the parapharyngeal space pps is a space in the suprahyoid neck that contains fat and is surrounded by several other spaces defined by the fascial layers of the neck. We report the mr imaging findings of a solitary fibrous tumor involving the parapharyngeal space. The case presented here is a 22yearold woman who was referred to our clinic with complaints of painless neck mass, dysphagia.
It occupies the space between muscles of mastication and the muscles of deglutition. Parapharyngeal space lesions are diagnosed late with imaging and fineneedle aspiration cytology. Tumors of the parapharyngeal space jama otolaryngologyhead. May 11, 2012 the tensor veli palatini fascia did not contribute to the posterior marginal fascia. Find out what nerves are found in the parapharyngeal space on the full version of this video. Both benign and malignant tumors may arise from any of the structures contained within the parapharyngeal space pps. It has clinical importance in otolaryngology due to parapharyngeal space tumours and parapharyngeal abscess developing in this area. Parapharyngeal dissection for papillary thyroid cancer. Since the introduction of antibiotics, the incidence of parapharyngeal abscess secondary to tonsillitis and peritonsillar abscess has decreased dramatically. Epidemiology a person of any age can develop a parapharyngea. The prestyloid compartment of the parapharyngeal space hereafter, the prestyloid space seems to correspond to a border between the first and second pharyngeal arch derivatives. Anatomical complexity and etiology med j malaysia vol 62 no 5 december 2007 415 medial displacement of the lateral pharyngeal wall and tonsil is a hallmark of a parapharyngeal space infection. This is part of the throat and, by extension, the digestive system. This article presents the spatial anatomy of the pps and describes the displacement patterns of the pps fat that are essential for accurate diagnosis and appropriate.
To illustrate the radiological anatomy of the parapharyngeal space pps. Prestyloid compartment of the parapharyngeal space. The exact anatomy of the deep fascial planes of the neck varies from. Sep 28, 2016 the parapharyngeal space pps is a potential space between the skull base above and the hyoid bone below. Recognize some forms of displacement of pps fat that are essential for accurate diagnosis and appropriate treatment of. The parapharyngeal space also termed the lateral pharyngeal space or prestyloid parapharyngeal space, shaped like a cone or a pyramid, inverted with its base at the sphenoid bone, with its apex inferiorly pointing to the greater cornu of the hyoid bone. Van rompaey j1, suruliraj a, carrau r, panizza b, solares ca. Menachem gross, ron eliashar, in orofacial pain and headache, 2008. Imaging of the parapharyngeal space operative techniques in. We present five cases of parapharyngeal abscess resulting from tonsillitis and peritonsillar. Sep 05, 2019 tumors of the parapharyngeal space pps, a potential space lateral to the upper pharynx, are uncommon, comprising less than 1% of all head and neck neoplasms. It is classed as one of the suprahyoid fascial spaces because it is situated on the lateral aspect of the pharynx and is continuous with the retropharyngeal space posteriorly and the submandibular space anteriorly. To allow better visualization and increased triangulation of a bimanual dissection technique, a sublabial canine fossa antrostomy was created.
The parapharyngeal space has also been referred to in the literature as the lateral pharyngeal, peripharyngeal, pharyngomaxillary, pterygopharyngeal, pterygomandibular, and pharyngomasticatory space, and its boundaries have been described with more variation than those of any other space of the neck. When dynamic scanning is used, diagnostic angiography or digital venous imaging dvi can be avoided in almost all of these cases. A major supplying artery of the space was the ascending palatine artery. The parapharyngeal space is described as a potential space located in the head and neck, particularly at the pharynx. Peritonsillar abscess and tonsillitis may result in parapharyngeal abscess. Anterior border pharynx and esophagus buccopharyngeal fascia posterior border alar layer of deep fascia superior border skull base inferior border superior mediastinum. Mar 18, 2019 transcervical excision of parapharyngeal and retropharyngeal lymph nodes requires a thorough understanding of the anatomy of the neck and parapharyngeal space, along with a stepwise surgical technique to safely expose the parapharyngeal space. Parapharyngeal space lesions hong kong journal of radiology. Mar 23, 2020 the parapharyngeal space is described as a potential space located in the head and neck, particularly at the pharynx. Health, general pharyngeal diseases care and treatment case studies diagnosis sarcoma throat diseases.
Fatcontaining masses of the prestyloid parapharyngeal. Parapharyngeal space pps is the anatomical area lateral to the upper pharynx and clinically important due to pps tumors. The parapharyngeal space pps is a fascial space in the suprahyoid neck, shaped like an inverted cone and extends from the skull base down to the level both side soft hypopharynx 1,2 figure 1. The parapharyngeal space is one of three potential spaces that can cause deep neck space infections retrophanygeal space. Figure 3 postsurgical mri gadolinium contrastenhanced t2weighted coronal and axial mri images demonstrate a residual t2 hypointense, enhancing soft tissue mass involving the anterior left maxillary sinus, premaxillary soft tissues, and extending superiorly into the extraconal soft tissues of the left orbit see arrows. Anatomy and common pathology of the parapharyngeal space epos. Parapharyngeal space the parapharyngeal space is shaped like a pyramid, inverted with its base at the skull base, with its apex inferiorly pointing to the greater cornu of the hyoid bone. It would be nice if you could find a better source.
And resection and repair of internal carotid artery aneurysm. Pdf parapharyngeal space is a suprahyoid neck space. It is also a key anatomic landmark for localizing disease processes in the surrounding spaces of. Tumors of parapharyngeal space iowa head and neck protocols. Fat containing tumors of the prestyloid parapharyngeal space are very. The parapharyngeal space pps is an inverted pyramidshaped deep space in the head and neck region, and a variety of tumors, such as salivary gland tumors, neurogenic tumors, nasopharyngeal. A new case of a branchial cyst of the parapharyngeal space. It consists largely of fat, neurovascular structures, and, in. To illustrate unusual congenital, developmental, benign, and malignant fatcontaining pps masses. Anatomy and common pathology of the parapharyngeal. Parapharyngeal space tumors are rare and account for 0. Anatomic specimens were dissected to define better the fascial layer representing the medial wall of the masticator space. Parapharyngeal abscesses are deep neck abscesses involving the parapharyngeal space. The parapharyngeal space pps is a fascial space in the suprahyoid neck, shaped like an inverted cone and extends from the skull base down to the.
Its borders include the nasopharynx and oropharynx medially, the masticator space anterolaterally, the deep lobe of the parotid gland posterolaterally, and the retropharyngeal space posteromedially fig. The parapharyngeal space pps is a space in the suprahyoid neck that contains fat and is surrounded by several other spaces defined by the fascial layers of the neck. Parapharyngeal space medical definition merriamwebster. The parapharyngeal space has also been referred to in the literature as the lateral pharyngeal, peripharyngeal, pharyngomaxillary, pterygopharyngeal, pterygomandibular, and pharyngomasticatory space, and its boundaries have been described with more variation than. The retropharyngeal space is continuous laterally with another potential space, the parapharyngeal space. Parapharyngeal space an overview sciencedirect topics. The parapharyngeal space pps is a potential space between the skull base above and the hyoid bone below. The parapharyngeal space may be divided into two compartments on the basis of its rela tionship to the styloid. We retrospectively studied tumors of the parapharyngeal space treated at the baylor college of medicine affiliated hospital system, houston, from 1972 to 1985. Recognize some forms of displacement of pps fat that are essential for accurate diagnosis and appropriate treatment of pathology arising in this region. Anatomical relations of presty loid pps and contralateral pleomorphic adenoma, to medial pterygoid, submandi bular salivary gland, and hyoid bone. The imaging anatomy of the parapharyngeal space pps. Mar 16, 2015 find out what nerves are found in the parapharyngeal space on the full version of this video. Encountering a parapharyngeal mass with cystic appearance on imaging, one should rule out thyroid malignancy as differential diagnosis.
Approaches to the parapharyngeal space plastic surgery key. Surgical and ct examinations of 104 patients, each of whom presented with a parapharyngeal space mass, has resulted in the development of an updated ct protocol designed to provide a preoperative diagnosis. Synonyms for parapharyngeal space in free thesaurus. The fascia that separates these two spaces is an ineffectual barrier to the spread of infection. A thyroid tumor extending to the parapharyngeal space bmc. Endonasal endoscopic transpterygoid approach to the upper. The parapharyngeal space was accessed endonasally by removal of the medial and posterior walls of the maxillary sinus. Common differentials of true pps lesions and their imaging features. Anatomy and common pathology of the parapharyngeal space. Head and neck clinic, case study by ear, nose and throat journal. This fascial space is also known as the lateral pharyngeal space. Transcervical excision of parapharyngeal and retropharyngeal lymph nodes requires a thorough understanding of the anatomy of the neck and parapharyngeal space, along with a stepwise surgical technique to safely expose the parapharyngeal space.
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