[Parapharyngeal space-occupying lesions. Differential diagnosis based on case examples].
BACKGROUND
Parapharyngeal tumors account for only 0.8% of all head and neck tumors which often presents the problem of preoperative diagnosis. Up to 80% of parapharyngeal tumors are benign.


METHODS
Starting November 1995 to March 2001, 16 patients with parapharyngeal tumors and 1 retropharyngeal abscess were treated. The median age was 54 years. Only 2 patients demonstrated peripheral nerve lesions preoperatively.


RESULTS
17 tumors and the retropharyngeal abscess were excised via transcervical approach, with an extension by parotidectomy and temporary mandibular split in 1 case. Histological entities were pleomorphic adenomas in 5 cases, a ganglioneurinoma, neurinoma of the vagal nerve and metastasis of a squamous cell carcinoma in 2 patients each, furthermore neuroblastoma, extramedullary plasmocytoma, T-cell lymphoma, and hemangioma in 1 patient each.


CONCLUSIONS
We demonstrate the differential diagnosis of parapharyngeal tumors as well as their diagnostic and therapeutic management. The tumors should be excised by a transcervical approach to protect cervical vessels and nerves, which is limited by a transoral approach.
Weber
A
A
Klinik für Hals-Nasen-Ohren-Heilkunde, plastische Operationen, Universitätsklinikum Leipzig, Liebigstrasse 18a, 04103 Leipzig.
Tannapfel
A
A
Kösling
S
S
Bootz
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010614:Pharynx / Q000473:pathology / Q000601:surgery; D017703:Retropharyngeal Abscess / Q000175:diagnosis / Q000473:pathology / Q000601:surgery