Management of Parapharyngeal Space Tumours

Objective: To determine the role of clinical features, fine needle aspiration cytology (FNAC) and computed tomography (CT) scan in diagnosing parapharyngeal space (PPS) tumours and treatment options.

Design: A descriptive study.

Place And Duration Of Study: From July 2000 to July 2002 at Pakistan Institute of Medical Sciences, Islamabad.

Patients And Methods: Patients diagnosed as having PPS tumours were studied. The medical record of patients was reviewed for their age, gender, clinical features, investigations (FNAC and CT scan) and treatment. The mean age, percentage of different clinical features and the sensitivity and specificity of FNAC was determined.

Results: The mean age of patients presenting with PPS tumours was 33.6 years. The most common clinical features were neck mass (93%) and bulge in lateral pharyngeal wall (80%). The CT scan showed exact location and extent of tumour in 11 out of 15 cases. The sensitivity and specificity of FNAC was 70% and 85% respectively. The most common tumours were neurogenic tumours (6) and salivary gland tumours (4). Surgery was performed in all except 2 patients with lymphoma in whom radiation and chemotherapy was recommended.

Conclusion: This study indicates that PPS tumours are usually benign neurogenous and salivary gland tumours presenting with neck mass and bulge in oropharynx. FNAC and CT scan are important in diagnostic work up and treatment planning. Surgery has the best results in most cases.