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 separation of the masticator and parapharyngeal spaces is somewhat ambiguous. To describe novel techniques for imaging fatcontaining lesions of the pps, such as ideal mri. Both benign and malignant tumors may arise from any of the structures contained within the parapharyngeal space pps.
Mar 16, 2015 find out what nerves are found in the parapharyngeal space on the full version of this video. It is a serious medical condition, potentially fatal, and requires prompt diagnosis and treatment. 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. When dynamic scanning is used, diagnostic angiography or digital venous imaging dvi can be avoided in almost all of these cases. The parapharyngeal space also termed the lateral pharyngeal space, is a potential space in the head and the neck. Mr imaging findings ae kyung jeong, ho kyu lee, sang yoon kim, and kyungja cho summary. Menachem gross, ron eliashar, in orofacial pain and headache, 2008. A new case of a branchial cyst of the parapharyngeal space. Epidemiology a person of any age can develop a parapharyngea. 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.
Endonasal endoscopic transpterygoid approach to the upper. To clearly define the anatomy of the prestyloid parapharyngeal space pps. The case presented here is a 22yearold woman who was referred to our clinic with complaints of painless neck mass, dysphagia and. A major supplying artery of the space was the ascending palatine artery. Background the pps is defined as the deepest space in the neck and it consists of the pre. Parapharyngeal space lesions are diagnosed late with imaging and fineneedle aspiration cytology. Access to parapharyngeal space vula university of cape town. Van rompaey j1, suruliraj a, carrau r, panizza b, solares ca. The case presented here is a 22yearold woman who was referred to our clinic with complaints of painless neck mass, dysphagia. 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. 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. Parapharyngeal space article about parapharyngeal space by. General anatomy regions of human body regions of head deep spaces of face and neck parapharyngeal space.
Anatomy and common pathology of the parapharyngeal space. Pdf surgical treatment results of parapharyngeal space tumors. Trismus, drooling, dysphagia, and odynophagia also are. 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. We report the mr imaging findings of a solitary fibrous tumor involving the parapharyngeal space. Parapharyngeal space synonyms, parapharyngeal space.
And resection and repair of internal carotid artery aneurysm. 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. Trismus, drooling, dysphagia, and odynophagia also are observed commonly. Mar 23, 2020 the parapharyngeal space is described as a potential space located in the head and neck, particularly at the pharynx. The tumor was a wellcircumscribed solid mass with a lobulated contour. The styloid process divides the pps into an anterior or prestyloid compartment and a neurovascular or poststyloid compartment. A fascial layer was found extending from the medial pterygoid muscle to the skull base separating the masticator from the parapharyngeal space. It has clinical importance in otolaryngology due to parapharyngeal space tumours and parapharyngeal abscess developing in this area. 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.
Approaches to the parapharyngeal space plastic surgery key. Solitary fibrous tumor of the parapharyngeal space. Any information contained in this pdf file is automatically generated from digital. Parapharyngeal dissection for papillary thyroid cancer. Tumors of the parapharyngeal space jama otolaryngologyhead. Infections arise from foci in the mandibular teeth, tonsils, parotid gland, deep cervical lymph nodes, middle ear, or sinuses. Parapharyngeal space lesions hong kong journal of radiology. The imaging anatomy of the parapharyngeal space pps. We present five cases of parapharyngeal abscess resulting from tonsillitis and peritonsillar. 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. Prestyloid compartment of the parapharyngeal space. Parapharyngeal abscess may cause lifethreatening complications. 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.
The parapharyngeal space may be divided into two compartments on the basis of its rela tionship to the styloid. 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. Find out what nerves are found in the parapharyngeal space on the full version of this video. 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.
Fatcontaining masses of the prestyloid parapharyngeal. The parapharyngeal space is divided into two compartments by a fascia, which extends from the styloid process to the tensor veli. The parapharyngeal space was accessed endonasally by removal of the medial and posterior walls of the maxillary sinus. Pdf parapharyngeal space is a suprahyoid neck space. I believe it is the same, but it been some time since i had anatomy of the neck. Parapharyngeal abscess radiology reference article. To allow better visualization and increased triangulation of a bimanual dissection technique, a sublabial canine fossa antrostomy was created. To describe the imaging features of a variety of disease processes that may occur in the pps. 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. 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.
Common differentials of true pps lesions and their imaging features. 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. Recognize some forms of displacement of pps fat that are essential for accurate diagnosis and appropriate treatment of. This is part of the throat and, by extension, the digestive system. Imaging of the parapharyngeal space operative techniques in. Since the introduction of antibiotics, the incidence of parapharyngeal abscess secondary to tonsillitis and peritonsillar abscess has decreased dramatically. Contents fat main component trigeminal nerve cn v internal maxillary artery ascending pharyngeal artery. There is already an article for retropharyngeal space. 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 parapharyngeal space pps is a potential space between the skull base above and the hyoid bone below.
Parapharyngeal abscesses are deep neck abscesses involving the parapharyngeal space. Salivary gland neoplasms benign to malignant ratio 3. 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. It is also a key anatomic landmark for localizing disease processes in the surrounding spaces of. The exact anatomy of the deep fascial planes of the neck varies from. Pdf role of imaging in the diagnosis of parapharyngeal space. Parapharyngeal space medical definition merriamwebster. The displacement patterns of pps fat that are essential for accurate diagnosis and appropriate treatment of pathology arising in this region.
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. Kazi core messages parapharyngeal space is a deepseated fascial space associated with adjoining fascial spaces and the infratemporal fossa having a complex anatomy. Peritonsillar abscess and tonsillitis may result in parapharyngeal abscess. To illustrate unusual congenital, developmental, benign, and malignant fatcontaining pps masses. It consists largely of fat, neurovascular structures, and, in some definitions, the retromandibular part of the deep lobe of the parotid gland. The metastasis of papillary thyroid carcinoma to the parapharyngeal space is rare and discussed in the english literature before.
Synonyms for parapharyngeal space in free thesaurus. Retropharyngeal space an overview sciencedirect topics. Head and neck clinic, case study by ear, nose and throat journal. Separation of the masticator space from the parapharyngeal space. Parapharyngeal space synonyms, parapharyngeal space antonyms. To demonstrate diagnostic approach of pps lesions by using ct and mr techniques. 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. 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 tensor veli palatini fascia did not contribute to the posterior marginal fascia. The medial and lateral pterygoid plates were removed. May 11, 2012 the tensor veli palatini fascia did not contribute to the posterior marginal fascia. Anterior border pharynx and esophagus buccopharyngeal fascia posterior border alar layer of deep fascia superior border skull base inferior border superior mediastinum. Encountering a parapharyngeal mass with cystic appearance on imaging, one should rule out thyroid malignancy as differential diagnosis. The retropharyngeal space is continuous laterally with another potential space, the parapharyngeal space.
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. Sep 28, 2016 the parapharyngeal space pps is a potential space between the skull base above and the hyoid bone below. Fat containing tumors of the prestyloid parapharyngeal space are very. Anatomy and common pathology of the parapharyngeal space epos. 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.
This fascial space is also known as the lateral pharyngeal space. Parapharyngeal space tumors are rare and account for 0. Recognize some forms of displacement of pps fat that are essential for accurate diagnosis and appropriate treatment of pathology arising in this region. Combines with buccopharyngeal fascia at level of t1t2. The roof of the parapharyngeal space pps is poorly defined. Parapharyngeal space pps is the anatomical area lateral to the upper pharynx and clinically important due to pps tumors. It occupies the space between muscles of mastication and the muscles of deglutition. The fascia that separates these two spaces is an ineffectual barrier to the spread of infection. The anatomical location of the parapharyngeal space is rather unique. Anatomy and common pathology of the parapharyngeal. The parapharyngeal space is described as a potential space located in the head and neck, particularly at the pharynx.
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. Health, general pharyngeal diseases care and treatment case studies diagnosis sarcoma throat diseases. 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. A thyroid tumor extending to the parapharyngeal space bmc. Anatomical relations of presty loid pps and contralateral pleomorphic adenoma, to medial pterygoid, submandi bular salivary gland, and hyoid bone. We retrospectively studied tumors of the parapharyngeal space treated at the baylor college of medicine affiliated hospital system, houston, from 1972 to 1985. Parapharyngeal space an overview sciencedirect topics. Anatomic specimens were dissected to define better the fascial layer representing the medial wall of the masticator space. The parapharyngeal space is one of three potential spaces that can cause deep neck space infections retrophanygeal space. The international federation of head and neck oncologic societiescurrent concepts in head and neck surgery and oncology 2012 parapharyngeal space tumors jatin p. The anatomy of the parapharyngeal space is complex and critical. Tumors of parapharyngeal space iowa head and neck protocols. Parapharyngeal space definition of parapharyngeal space by. It consists largely of fat, neurovascular structures, and, in.
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