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.