Parapharyngeal space tumors 1 parapharyngeal space tumors. A new case of a branchial cyst of the parapharyngeal space. Radiological anatomy most definitive collection of. View notes parapharyngealtumorslides060322 from step 1 at montgomery college. Only 20% of these neoplasms are malignant and 50% of these neoplasms arise from the deep lobe of the parotid gland or minor salivary glands. Kazi core messages parapharyngeal space is a deepseated fascial space associated with adjoining fascial spaces and the infratemporal fossa having a complex anatomy.
If more than half of the size of the c2 vertebra, it may indicate retropharyngeal abscess. The anatomical location of the parapharyngeal space is rather unique. Ppt parapharyngeal space tumors powerpoint presentation. Furthermore, a clinical division of the parapharyngeal space in the superiorinferior axis is established. 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. Since the introduction of antibiotics, the incidence of parapharyngeal abscess secondary to tonsillitis and peritonsillar abscess has decreased dramatically. Retromandibular portion of the deep lobe of the parotid glandthe parotid gland minor or ectopic salivary gland cn v branch to tensor veli palatini musclecn v branch to tensor veli palatini muscle ascending pharyngeal artery and venous plexus most fat.
Contents fat main component trigeminal nerve cn v internal maxillary artery ascending pharyngeal artery. Radiological anatomy is crucial for radiologists and forms the base for learning radiology. Gross anatomy surface anatomyanatomy that we can see at the surface of the body everyday life regional anatomycomplete anatomy internal of a specific region of the body learning every blood vessel, muscle, bones, etc. Management of parapharyngeal and retropharyngeal space. Parapharyngeal space synonyms, parapharyngeal space antonyms.
Recognize some forms of displacement of pps fat that are essential for accurate diagnosis and appropriate treatment of pathology arising in this region. It occupies the space between muscles of mastication and the muscles of deglutition. The masticator and parotid spaces are located laterally, the pharyngeal mucosal. Anatomy of the parapharyngeal space potential space inverted pyramid with floor at skull base, tip at hyoid, and bounded by the pharyngeal wall medially and the mandible2012 laterally 4. 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. The parapharyngeal space pps is a potential space between the skull base above and the hyoid bone below. The authors present imaging anatomy of the parapharyngeal space. Contents 1 prestyloid part of parapharyngeal space. The pharynx is a 5 inches long tube which runs behind the nasal cavity, the oral cavity and into the upper esophagus and respiratory tract.
The anatomy emphasizes the expansile nature of the space and also the close proximity of. The parapharyngeal space was accessed endonasally by removal of the medial and posterior walls of the maxillary sinus. The retropharyngeal space appears as a small, roughly rectangular space on axial imaging, wider in the mediolateral dimension and thinner in the anteroposterior dimension. May 01, 2020 the parapharyngeal space is described as a potential space located in the head and neck, particularly at the pharynx. To describe the imaging features of a variety of disease processes that may occur in the pps. Tumors of parapharyngeal space iowa head and neck protocols.
Based on the ct appearance and enhancement characteristics, it is difficult to accurately distinguish a minor salivary gland tumor from a neurogenic tumor. Surgical access to parapharyngeal space tumours the. The parapharyngeal space, an inverted pyramidshaped region, extends from the skull base to the greater cornu of the hyoid bone. Parapharyngealtumorslides060322 primary parapharyngeal. Anatomy and common pathology of the parapharyngeal space. The parapharyngeal space also termed the lateral pharyngeal space, is a potential space in the head and the neck. Article information, pdf download for roof of the parapharyngeal space. Often, a parapharyngeal space pps lesion is discovered incidentally on routine physical examination. The importance of the parapharyngeal space also lies in its relationship with the other spaces of the neck. Endonasal endoscopic transpterygoid approach to the upper. It sits posterior to the buccopharyngeal layer of middle cervical fascia which covers the esophagus and the pharynx and is anterior to the alar fascia.
The anatomy emphasizes the expansile nature of the space and also the close proximity of vital structures. A thyroid tumor extending to the parapharyngeal space. Parapharyngeal dissection for papillary thyroid cancer. The parapharyngeal space is shaped like an inverted pyramid. 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. Salivary gland neoplasms benign to malignant ratio 3. Parapharyngeal space tumor manifesting as an oropharyngeal mass.
Any information contained in this pdf file is automatically generated from digital material. An appreciation of the complex anatomy of potential spaces and fascial planes of the neck is vital to understanding lesions and their potential complications. Find out what nerves are found in the parapharyngeal. However without treatment infections can easily spread from one space to the adjacent space. Pdf role of imaging in the diagnosis of parapharyngeal space. Anatomy and common pathology of the parapharyngeal space epos. It is also a key anatomic landmark for localizing disease processes in the surrounding spaces of the neck. This is because it is a blind space enclosing important neurovascular structures with the tumour occasionally arising from the nerve sheath itself. The displacement patterns of pps fat that are essential for accurate diagnosis and appropriate treatment of pathology arising in this region. The surgical access to parapharyngeal space tumours is limited and difficult.
So this page would be listing all the books that are one of the best human anatomy books. The complex 3dimensionality of the itf and the upper parapharyngeal space needs a sound knowledge of the surgical anatomy. 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. Synonyms for parapharyngeal space in free thesaurus. Parapharyngeal abscess may cause lifethreatening complications. Common differentials of true pps lesions and their imaging features. Characteristics of reported cases of branchial cyst in the parapharyngeal space author age sex treatment magnotti, 1927 1 8 f excision guissani, 1928 2 25 m excision hoogland, 1951 3 69 m aspiration taylor and burwell, 1954 4 53 m aspiration and sclerosant injection 49 m aspiration 54 m aspiration and sclerosant injection mills, 1959 5 52 f. 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.
Pdf parapharyngeal space is a suprahyoid neck space. On this a part of the article, it is possible for you to to entry the. Tumors must be at least 2 cm in size before the bulge or abnormality is palpable. Parapharyngeal space tumors are rare and account for 0. Behind both the parapharyngeal space and carotid space lies the retropharyngeal space, and deep to this a potential space known as the danger. Parapharyngeal space an overview sciencedirect topics. 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 treatment of. The majority of tumors involving the parapharyngeal space are from the deep portion of the parotid gland or from minor salivary glands, and the majority of these tumors are benign mixed tumors. The retropharyngeal space is a fascial space that transverses the length of the neck in its entirety. To illustrate the radiological anatomy of the parapharyngeal space pps. To allow better visualization and increased triangulation of a bimanual dissection technique, a sublabial canine fossa antrostomy was created. The parapharyngeal space is a potential space in the head and the neck. As this site is about medical pdfs so here we would be talking only about medical subjects.
Trismus, drooling, dysphagia, and odynophagia also are observed commonly. Medical definition of parapharyngeal space merriamwebster. 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. 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. The hyoid bone is the main anatomical structure that limits the spread of infection. The retropharyngeal space is a potential space which is directly related to the danger space, the pharyngeal mucosal space, the carotid space and the parapharyngeal space. Parapharyngeal space mass laryngology jama otolaryngology.
Mar 16, 2015 the pharynx is a 5 inches long tube which runs behind the nasal cavity, the oral cavity and into the upper esophagus and respiratory tract. I have found the following websites quite useful for learning normal imaging anatomy and would recommend. The role of the same landmarks changed in different approaches. Intraoperatively, the mass was noted to be soft, friable, and well encapsulated, and it extended into the parapharyngeal space. Prestyloid compartment masticator space fat retromandibular parotid lymph nodes2012. This is part of the throat and, by extension, the digestive system. To demonstrate diagnostic approach of pps lesions by using ct and mr techniques. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.
Tumors of the parapharyngeal space jama otolaryngology. In view of the above, a careful meticulous dissection is required via a safe approach like the. A proposal for a level for parapharyngeal extension of parotid gland. Parapharyngeal space tumor manifesting as a neck mass. Both benign and malignant tumors may arise from any of the structures contained within. The imaging anatomy of the parapharyngeal space pps. These lesions could be classified as being either hypervascular glomus tumors or metastatic kidney, thyroid, or venous hemangiomas or hypovascular salivary gland tumors, neurogenic tumors, lymphomas, sarcomas. 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. The lesion caused loss of the fat plane between the parapharyngeal space and masticator space with subsequent inflammation of the pterygoid space.
Anatomy and common pathology of the parapharyngeal. Epidemiology a person of any age can develop a parapharyngea. Parapharyngeal space is divided by styloid septum, which runs from stylohyoid lig. We now have uploaded atlas of human anatomy pdf to our online repository to make sure easeofaccess and security. Parapharyngeal space pps is the anatomical area lateral to the upper pharynx and. The usefulness of this classification in helping the surgeon to decide which surgical approach is the most suitable for a particular lesion is discussed. Mid this article has been rated as midimportance on. 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. Prestyloid muscular compartment medialtonsillar fossa lateralmedial pterygoid contains fat, connective tissue, nodes poststyloid neurovascular compartment carotid sheath cranial nerves ix, x, xi, xii sympathetic chain stylopharyngeal aponeurosis. It consists largely of fat, neurovascular structures, and, in some definitions, the retromandibular part of the deep lobe of the parotid gland. Pdf surgical treatment results of parapharyngeal space tumors. Peritonsillar abscess and tonsillitis may result in parapharyngeal abscess.
It has clinical importance in otolaryngology due to parapharyngeal space tumours and parapharyngeal abscess developing in this area. Parapharyngeal space definition of parapharyngeal space. Nov 15, 2007 to study the circumstances of diagnosis, predisposing factors, bacteriology and therapeutic management of parapharyngeal abscesses. Parapharyngeal abscess radiology reference article. Dec 01, 20 the patient underwent an urgent transoral excision biopsy of the left parapharyngeal space mass and a bilateral tonsillectomy figure 2. Parapharyngeal space spatium parapharyngeum is space lateral and dorsolateral to pharynx, medially continues into retropharyngeal space boundaries. This article is within the scope of wikiproject anatomy, a collaborative effort to improve the coverage of anatomy on wikipedia. Primary parapharyngeal space pps tumors are one of the most challenging head and neck tumors to diagnose and treat.
April 08, 2020 the fascial spaces are theoretical spaces that are created between the layers of the deep cervical fascia and are filled with loose areolar connective tissue. 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. Start this article has been rated as startclass on the projects quality scale. Lateral and inferior to the parapharyngeal space is the carotid sheath, containing the internal carotid artery and cranial nerves ix, x and xi. 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 anatomy of the parapharyngeal space is complex and critical. 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. 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. We completed macroanatomical and microanatomical dissections in 10.
The hyoid bone is the main anatomical structure that limits the. The parapharyngeal space may be divided into two compartments on the basis of its relationship to the styloid process or, more precisely, to the tensorvascularstyloid fascia fig. Parapharyngeal abscesses are deep neck abscesses involving the parapharyngeal space. We retrospectively studied tumors of the parapharyngeal space treated at the baylor college of medicine affiliated hospital system, houston, from 1972 to 1985. Tumors of this space are rare, accounting for 0, 5 % of head and neck neoplasms. We analyzed our experience in patients with pps tumors who. The parapharyngeal space is a potential space occupied by adipose tissue, cranial nerves v, ix, xi, and xii, the deep cervical lymph nodes, and the ascending pharyngeal and maxillary arteries. Parapharyngeal space definition of parapharyngeal space by. Any information contained in this pdf file is automatically generated from digital. Parapharyngeal space article about parapharyngeal space by. May 31, 2011 neurogenic tumor in parapharyngeal space by dr. Deep neck space infections involving the parapharyngeal space ppsor retropharyngeal space rps are potentially lifethreatening conditions.
Background the pps is defined as the deepest space in the neck and it consists of the pre. The pharyngeal mucosa of the left lateral pharyngeal wall was effaced owing to mass effect figure, a. We present five cases of parapharyngeal abscess resulting from tonsillitis and peritonsillar. Approaches to the parapharyngeal space plastic surgery key. Bony anatomy around the space includes the skull base superiorly, and the greater cornu or greater. A midline raphe is present in this space making some infections appear unilateral. It is continuous with the parapharyngeal space anteriorly and the sublingual space. Tumors of the parapharyngeal space pps are rare, accounting for 0. Tumors of the parapharyngeal space jama otolaryngologyhead. Parapharyngeal space lesions are diagnosed late with imaging and fineneedle aspiration cytology. Anatomy books pdf all medical pdfs download pdf files. Total knee replacement surgery part 2 update 2011 duration. In their first year, residents should be well versed with normal radiographs, ultrasound and ct anatomy followed by mri in the consequent years. Due to the anatomical topography of pps and its content with the essential vessels and the lower.
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