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. Note the mylohyoid muscle large arrow and hyoglossus muscle small arrow, which define the margins of the sublingual space. Health, general pharyngeal diseases care and treatment case studies diagnosis sarcoma throat diseases. 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. The parapharyngeal space pps is a potential space between the skull base above and the hyoid bone below. Pdf surgical management of parapharyngeal space tumours. Parapharyngeal space synonyms, parapharyngeal space antonyms. Here, three giant pleomorphic adenomas of different sizes occupying the parapharyngeal space in three patients are reported. The pharyngeal mucosal, parapharyngeal, and retropharyngeal. Parapharyngeal space cysts, besides salivary gland origin may be derived from the first and dorsal portions of the second pharyngeal pouches. 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. Tumors in the parapharyngeal space deep within the neck under the jaw bone can be particularly difficult to reach and often require an incision in the neck and rarely a.
Normal anatomic spaces are shown on the right side of the diagram. The metastasis of papillary thyroid carcinoma to the parapharyngeal space is rare and discussed in the english literature before. 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. Boundaries superiorskull base inferiorhyoid anteriorptyergomandibular raphe posteriorprevertebral fascia medialbuccopharyngeal fascia lateralsuperficial layer of deep fascia parapharyngeal space. The retropharyngeal space is continuous laterally with another potential space, the parapharyngeal space. Parapharyngeal space article about parapharyngeal space by. The retropharyngeal space rps is bordered anteriorly by the visceral fascia and posteriorly. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The parapharyngeal pharyngomaxillary space is lateral to the superior pharyngeal. Management of parapharyngeal space cysts the journal of. Most parapharyngeal space masses benign, removed through. The masseteric space immediately anterior to the parapharyngeal space. Parapharyngeal spaces, rc706b, 12020629, hugh curtin, 1 the participant should be able to separate lesions that occur in the prestyloid parapharyngeal space from those in the post or retrostyloid parapharyngeal carotid space and from those in the masticator space. Head and neck clinic, case study by ear, nose and throat journal.
Tumors of the parapharyngeal space department otolaryngology head and neck surgery disclosure principal investigator. The anatomy of the neck is complex with critical structures of the airway. It is an inverted coneshaped potential space that extends from the hyoid bone to the base of the skull. 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. Use parapharyngeal space boundaries in dating the tool above to book your appointment. The parapharyngeal space pps is one of the most fascinating anatomic areas of the head and neck.
They are normally confined to treatment within a tertiary referral center due to their histological diversity and complex surrounding anatomy. Approach to masses in head and neck spaces springerlink. 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. Parapharyngeal space definition of parapharyngeal space. Parapharyngeal abscess abscess parapharyngeal space. In the suprahyoid neck, the contents of the visceral space are the naso and. Old text books divided this space into prestyloid and post stymoid compartments.
Health, general cysts care and treatment medicine otolaryngology practice pharynx surgery. 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. The parapharyngeal pharyngomaxillary space is lateral to the superior pharyngeal constrictor and medial to the pterygoid muscle. A new case of a branchial cyst of the parapharyngeal space. Tumors of the parapharyngeal space, although mostly benign in their histopathology, present a challenge to the surgeon due to the limited access. Defining its boundaries and clinical implications article in the annals of otology, rhinology, and laryngology 14. 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. Article a simplified approach to the spaces of the suprahyoid neck. Parapharyngeal space pps tumours are very rare and account for only 0. Mar 23, 2020 the parapharyngeal space is described as a potential space located in the head and neck, particularly at the pharynx. 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. The parapharyngeal space or lateral pharyngeal or pharyngomaxillary space is in the upper neck above the hyoid bone. Access to parapharyngeal space vula university of cape town.
Management of tumors of the parapharyngeal space cancer. The retropharyngeal space is a potential space of the head and neck, bounded by the buccopharyngeal fascia anteriorly and the alar fascia posteriorly. Ji hoon shin 1, ho kyu lee 1, sang yoon kim 2, choong gon choi 1 and dae chul suh 1. Symptoms include fever, sore throat, odynophagia, and swelling in the neck down to the hyoid bone. 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. A thyroid tumor extending to the parapharyngeal space. This space connects to every other major fascial neck space and is divided into anterior and posterior compartments by the styloid process. When dynamic scanning is used, diagnostic angiography or digital venous imaging dvi can be avoided in almost all of these cases. Lateral and inferior to the parapharyngeal space is the carotid sheath, containing the internal carotid artery and cranial nerves ix, x and xi.
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. Parapharyngeal space an overview sciencedirect topics. Although primary tumours of the parapharyngeal space are rare and account for only 0. Parapharyngeal space spatium parapharyngeum is space lateral and dorsolateral to pharynx, medially continues into retropharyngeal space boundaries. Pdf parapharyngeal space is a suprahyoid neck space. Parapharyngeal space article about parapharyngeal space.
Contents of the pharyngeal mucosal space include the mucosa of the nasopharynx and. Bony anatomy around the space includes the skull base superiorly, and the greater cornu or. Synonyms for parapharyngeal space in free thesaurus. Parapharyngeal definition of parapharyngeal by medical. The case presented here is a 22yearold woman who was referred to our clinic with complaints of painless neck mass, dysphagia. The parapharyngeal space is one of three potential spaces that can cause deep neck space infections retrophanygeal space. Parapharyngeal space is one of potential facial planes for neoplasms and infections and represents less than 1% of all head and neck tumours. The parapharyngeal space is described as a potential space located in the head and neck, particularly at the pharynx. The parapharyngeal space ppsp, previously known as lateral pharyngeal space, pharyngomaxillary space, pterygopharyngeal space, pterygomandibular space, or pharyngomasticatory space, is important by virtue of its location, although the tumors of the space are relatively uncommon 0. Salivary gland neoplasms benign to malignant ratio 3. Definition of parapharyngeal space nci dictionary of cancer. Occurrence of the pleomorphic adenoma in the parapharyngeal space is a rarity. A parapharyngeal abscess, roughly defined as an infection of the parapharyngeal space, is seen after dissemination of other more common deep neck space infections for example peritonsillar, tonsillar, or retropharyngeal abscesses, as well as tonsillitis 1 2 3, or previous upper respiratory tract infections 4, but it may be the primary.
The parapharyngeal space is shaped like an inverted pyramid. It consists largely of fat, neurovascular structures, and, in. However without treatment infections can easily spread from one space to the adjacent space. The parapharyngeal space pps is a deep space of the neck shaped as a tilted up pyramid with its. 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. Sep 28, 2016 the parapharyngeal space pps is a potential space between the skull base above and the hyoid bone below. A combined neurosurgery and otolaryngology lectureanatomic dissection course for senior level residents. Parapharyngeal space synonyms, parapharyngeal space. It consists largely of fat, neurovascular structures, and, in some definitions, the retromandibular part of the deep lobe of the parotid gland. 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.
This book covers maxillofacial and oral surgery, otorhinolaryngology, plastic surgery. Infections arise from foci in the mandibular teeth, tonsils, parotid gland, deep cervical lymph nodes, middle ear, or sinuses. Tumors of parapharyngeal space iowa head and neck protocols. A lateral pharyngeal space infection can spread to the carotid sheath, causing. Parapharyngeal space tumors are rare and account for 0. The retropharyngeal space is a fascial space that transverses the length of the neck in its entirety.
Axial t1 weighted mr image showing normal radiological anatomy of. It can be split into the retropharyngeal space and the parapharyngeal space. Encountering a parapharyngeal mass with cystic appearance on imaging, one should rule out thyroid malignancy as differential diagnosis. The retropharyngeal space appears as a small, roughly rectangular space on axial imaging, wider in the mediolateral dimension and thinner in the anteroposterior dimension. 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. Parapharyngeal abscess msd manual professional edition. Infections in the parapharyngeal space usually originate in the tonsils or pharynx, although local spread from odontogenic sources and. Parapharyngeal space spatium parapharyngeum is space lateral and dorsolateral to pharynx, medially continues into retropharyngeal space. If more than half of the size of the c2 vertebra, it may indicate retropharyngeal abscess. Abstract tumors of the parapharyngeal space, although mostly benign in their histopathology, present a challenge to the surgeon due to the limited access. The parapharyngeal space also termed the lateral pharyngeal space, is a potential space in the head and the neck. Behind both the parapharyngeal space and carotid space lies the retropharyngeal space, and deep to this a potential space known as the danger space. 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 role of imaging in the diagnosis of parapharyngeal space.
Its complex location and its relationship to the skull base, to the deep spaces of the neck, and to the neurovascular structures that traverse it are intimidating enough to keep the novice far from it. Clinical anatomy of the masticatory apparatus peripharyngeal spaces. Imaging of parapharyngeal spaces dre 4 dr mamdouh mahfouz duration. It is continuous with the parapharyngeal space anteriorly and the sublingual space. Mar 01, 2014 tumors in the parapharyngeal space deep within the neck under the jaw bone can be particularly difficult to reach and often require an incision in the neck and rarely a cut through the jaw bone. When the tumor is large, it extends into the parapharyngeal space and then difficulties arise. 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. It will also give an extremely brief example of the pathology associated with the fascial spaces. The importance of the parapharyngeal space also lies in its relationship with the other spaces of the neck.
A midline raphe is present in this space making some infections appear unilateral. Retropharyngeal space an overview sciencedirect topics. It is also a key anatomic landmark for localizing disease processes in the surrounding spaces of. Parapharyngeal space medical definition merriamwebster. Grant, in pediatric respiratory medicine second edition, 2008. Approximately 50% of the tumours have a salivary origin, 20% are neurogenic and the remaining 30% are represented by tumours such as benign and malignant lymphoreticular lesions, metastatic lesions and carotid body tumours.
Parapharyngeal abscess merck manuals professional edition. Parapharyngeal space infections ppsi may follow an infection in the pharynx, tonsils. This fascial space is also known as the lateral pharyngeal space. The parapharyngeal space extends inferiorly tapering to the apex of the pyramid, represented by the greater cornu of the hyoid bone figure 1. This is part of the throat and, by extension, the digestive system. It consists largely of fat, neurovascular structures, and, in some definitions. So far, cumulative literature on this topic is limited to singlecenter case reports or case series. 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. Are you ready for the parapharyngeal space boundaries in dating treat of a lifetime. The parapharyngeal space is a potential space in the head and the neck.
These have been described as dumbbell or round tumors. Prestyloid part of parapharyngeal space edit edit source prestyloid part of parapharyngeal space paratonsilar space is the very most ventral part of parapharyngeal space. Approaches to the parapharyngeal space plastic surgery key. This article incorporates text in the public domain from page 390 of the 20th edition of grays anatomy 1918. They are mucosal or epithelial lined structures with no external or visceral opening and always present on the lateral aspects of the nasopharyngeal wall. This book is distributed under the terms of the creative commons. A triangular area near the pharynx throat, between the base of the skull and the hyoid bone the bone under the tongue. Posteriorly, the space is bounded by the prevertebral fascia, prevertebral muscles, and vertebrae.
The international federation of head and neck oncologic societiescurrent concepts in head and neck surgery and oncology 2012 parapharyngeal space tumors jatin p. Prepare yourself for a escort dating experience like you never imagined. Contents fat main component trigeminal nerve cn v internal maxillary artery ascending pharyngeal artery. Parapharyngeal space lesions are diagnosed late with imaging and fineneedle aspiration cytology.
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