Differential Diagnosis and Treatment of Tumors of the Parapharyngeal Space

Tumors of the parapharyngeal space, especially benign tumors, may grow slowly and asymptomatically or may cause atypical symptoms of pain or dysphagia. There is an asymmetry of the lateral oro- or hypopharynx wall and dislocation of the ipsilateral tonsil to the midline. Magnetic resonance imaging is essential in demonstrating the tumor, its margins, and its relation to the adjacent structures such as the internal and external carotid arteries, the internal jugular vein, the pterygoid muscles, and the sphenoid bone, as well as its vascularity. In the last 10 years we have treated large parapharyngeal tumors, mainly pleomorphic adenomas of the parotid gland, one adenocystic carcinoma, and three schwannomas. All tumors were successfully removed via a submandibular approach without previous biopsy.