title: Neurilemomas of the parapharyngeal space.
abstract: OBJECTIVE
  To review the surgical management of neurilemomas of the parapharyngeal space (PPS).
  
  
  METHODS
  Retrospective survey of the clinical presentation, radiological features, surgical approaches, surgical findings, and postoperative neurological sequelae of neurilemomas of the PPS.
  
  
  METHODS
  Academic tertiary care head and neck referral center.
  
  
  METHODS
  Fourteen patients with neurilemomas of the PPS, 12 were in the poststyloid compartment.
  
  
  METHODS
  Preoperative evaluation with computed tomography and/or magnetic resonance imaging with or without angiography. Surgical resection was performed through a transcervical approach.
  
  
  METHODS
  Radiological features, adequacy of surgical approach, and neurological sequelae of surgery.
  
  
  RESULTS
  Radiological studies could distinguish prestyloid from poststyloid tumors and, with poststyloid tumors, can usually differentiate between glomus tumor and neurilemoma. The transcervical approach permitted adequate surgical access. Five of the tumors in the poststyloid space were neurilomomas originating from the sympathetic nervous system, and all 5 patients with these tumors developed Horner syndrome postoperatively.
  
  
  CONCLUSIONS
  Computed tomographic and/or magnetic resonance studies should be routinely obtained to evaluate tumors of the PPS, but angiography is indicated only in selected cases. Both prestyloid and poststyloid neurilemomas can be resected through a transcervical approach. Resection of neurilemomas has an attendant risk for neurological dysfunction.
authors.affiliation: Department of Otolaryngology, Alexandria University, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Hamza
authors.forename: J J
authors.initials: JJ
authors.lastname: Fagan
authors.forename: J L
authors.initials: JL
authors.lastname: Weissman
authors.forename: E N
authors.initials: EN
authors.lastname: Myers
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006732:Horner Syndrome / Q000453:epidemiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed