Pharyngeal space lesions

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Several different tumours can present in the parapharyngeal space.

Contents

Anatomy

The parapharyngeal space is a potential space lateral to the oropharynx and nasopharynx. It is divided into anterior and posterior compartments by the styloid process.The anterior space (also called the pre-styloid space) represents a potential site for abscesses or tumours. The posterior compartment (also called the post-styloid space) contains the carotid sheath. Medial and posterior to the carotid sheath are loose areolar tissue. This region also represents a potential site for infections.

Tumours of the pharyngeal space

Common tumours include

Neurofibromas

Schwannomas

  • Neural crest origin
  • Arise from Schwann cells
  • Encapsulated tumours
  • Rarely cause weakness of affected nerve

Chemodectomas

These tumours arise from neural crest syncitioblasts. There are two main types.

  • Carotid body tumours arise from preganglionic tissue on the medial side of the carotid bulb. They are vascular tumours associated with high altitude.
  • Vagal paragangiomas arise from preganglionic tissue inside the vagus nerve. They are called glomus vagale tumours, or if they present just below the jugular foramen, glomus jugulare tumours.