Clinical Study of Parapharyngeal Space Tumors

Tumors arising in the parapharyngeal space are rare. We reviewed 13 cases of parapharyngral space tumors that had been operated on between 1999 and 2004, and investigated the preoperative diagnosis, method of operation, and complications after surgery. Computed tomography, magnetic resonance imaging and fine-needle aspiration cytology were very useful for preoperative diagnosis, judging the extent of involvement and localization, and assessing the pathology of the tumor in the parapharyngeal space. The pathological diagnosis of these tumors was pleomorphic adenoma (6 cases), neurilemmoma (5 cases), ganglioneuroma (1 case), and malignant pleomorphic adenoma (1 case). The cervical approach was the most common, and was used in seven cases. Other surgical approaches included the cervical approach with mandibulotomy (2 cases), cervical-parotid approach (2 cases), and parotid approach (2 cases). First bite syndrome (FBS) has recently been reported as a complication after surgical removal of parapharyngeal space tumors. We experienced 4 cases of FBS. Since FBS was very difficult to treat in these patients, it is necessary to be aware of this syndrome.