A. S. Aruna Kumari 1 , G. Sreekanth 2 , Juveria Majeed 3 , Naveed Ahmed
ABSTRACT: INTRODUCTION: Parapharyngeal tumors are rare, comprising approximately 0.5% of all head and neck tumours. Most of them are benign. These tumors present with difficulties in diagnosis - complementary MRI and CT scanning are necessary for diagnosis, and Fine Needle Aspiration Cytology (FNAC) is very specific in the histological diagnosis of these tumours. Open biopsy is not advisable due to bleeding, breaching of the capsule and seeding of the tumor. These tumors presents a challenge to the surgeon due to its anatomical complexities. This study deals with the incidence and management of various parapharyngeal tumors. OBJECTIVE OF THE STUDY: This study deals with the incidence of various tumors in the parapharyngeal space in different age and sex groups, role of sophisticated diagnostic modalities like CT, MRI, MR Angio. Colour Doppler along with FNAC and various surgical approaches to this space. This study also deals with intra-operative and post operative complications. In this series, a total of 25 cases has been studied retrospectively in a time period of 2 years from 2012 to 2014, presenting in our ENT and Head and Neck Dept., Gandhi hospital. RESULTS: According to this study, there is male preponderance (52%) and highest incidence is seen in 3rd and 5th decade (24% each). Most common presenting symptoms are difficulty in swallowing (36%) and swelling either intraoral or in the neck (28%). Least common symptoms being cranial nerve palsy (4%), difficulty in breathing/noisy breathing (4%), nasal regurgitation (4%) and hard of hearing (8%). FNAC was done in 21 cases, in which 13 were correlating with the biopsy report. CT scan was required in all cases. MR Angiography was done in 4 cases and colour Doppler in 2 cases. Surgery is the mainstay of the treatment. Most common tumor in PPS is neurogenic (schwannoma/neurofibroma).i.e 44%. Next commonly occurring tumor in our study is of salivary origin-pleomorphic adenoma (24%), paragangliomas (12%). Other less commonly seen tumors are AV malformation, epidermal cyst, rhabdomyosarcoma, mucoepidermoid ca., fibroangioma.
