1. Introduction:
Parapharyngeal space (PPS) is an imaginary inverted pyramidal space with an extension from skull base to the hyoid bone divided by Riolan’s bundle into pre- and post-styloid compartments [1-3]. Of all head and neck cancers, PPS tumors account for 0.5 % and mostly are benign (80%) with diverse histology. Pleomorphic adenoma is the most common benign tumor of salivary gland origin occupying mostly pre-styloid compartment and Schwannomas as the most common neurogenic entity residing in the post-styloid space [4]. The correct histopathological diagnosis of these lesions may not be achieved due to complex anatomical location relying more on image findings (Computerized tomography, Magnetic resonance imaging or Angiography) for preliminary diagnosis. This may also help in identifying the anatomical extent of the growth [1]. Surgery has stayed as the primary treatment modality if not contraindicated by gross intracranial tumor extension or co-morbidities pushing towards other non-surgical treatment options [5]. A lot of literature including case series and reports has been published regarding parapharyngeal space tumors with diverse benign and malignant histology including all the deep lobe parotid, infra-temporal fossa tumors as well as carotid body paragangliomas. [6]. Previous published data have reported neurological complications to be a common observation among PPS tumors [5-7]. We have aimed our study more on the tissue of tumor origin in benign parapharyngeal space tumors and its relation to neurological deficit. A thorough search was conducted by reviewing all the available relevant published data to focus on the rationale behind high incidence of associated neurological complications.