ABSTRACT
INTRODUCTION:Parapharyngeal space tumours are uncommon in head neck region. They are situated in a deep and complicated potential neck space. Mainstay of management remains surgical excision, though it is very difficult and complication prone. MATERIAS & METHODS:Aretrospective clinical study was done on 54 cases of primary PPS tumour. Their mode of presentation , imaging, cytopathology and histopathology results were noted. Different surgical approaches was evaluated.RESULTANALYSIS: Benign tumour was found in 81.5% cases. Salivary gland tumours were most common followed by schwannoma. CTscan is the first line investigation. Transcervical route is the most common surgical approach. CONCLUSION:Different types of tumours are found in PPS. Mortality and morbidity is related with surgery itself rather than the disease process. So surgeon must respect his learning curve.
ABSTRACT
Os paragangliomas são tumores altamente vascularizados frequentemente benignos e unilaterais. Localizados no corpo carotídeo, predominam no espaço parafaríngeo. O objetivo deste relato é apresentar um caso de paraganglioma de corpo carotídeo unilateral com extensão ao espaço parafaríngeo. Paciente feminina, 66 anos, observou a presença de assimetria na região amigdalina à direita há aproximadamente um ano sem outros sintomas. A oroscopia e a videotelelaringoscopia evidenciaram assimetria da loja amigdalina direita com suspeita de massa expansiva que projetava a amígdala e pilar posterior para a linha média estendendo-se inferiormente até a vertente externa do seio piriforme. No exame do pescoço apresentava à direita extensão da massa para a região júgulo-carotídea (nível II) de consistência aumentada. A suspeita clínica de glomus foi confirmada por estudo tomográfico computadorizado contrastado do pescoço, ressonância nuclear magnética e angiorressonância de vasos cervicais que definiram uma lesão ovalada com 5X4X6 cm, na topografia do espaço carotídeo direito, deslocando a artéria carótida externa e interna na região do bulbo carotídeo, hipervascularizada, com extensão ao espaço parafaríngeo e sugestiva de paraganglioma carotídeo. O tratamento indicado foi a ressecção cirúrgica sem a realização de embolização prévia. O paraganglioma carotídeo é um tumor raro e de crescimento lento que acomete a região júgulo-carotídea. A extensão parafaríngea é rara e deve estar no diagnóstico diferencial das patologias do espaço parafaríngeo (AU)
Paragangliomas are highly vascularized tumors often benign and unilaterais. Located in the carotid body, they predominate within parafaringeo space. The aim of tyhis repor was to describe a case of unilateral carotid body paraganglioma extending into space parafaríngeo. A female, 66 years-old patient noted the presence of asymmetry in the tonsillar region right about 1 year without other symptoms symptoms. Oroscopy and videotelelaryngoscopy showed asymmetry in right tonsillar store with suspected expansive mass that projected the amygdala and posterior pillar to the middle line extending inferiorly to the lateral aspect of the piriform sinus. On examination of the neck showed right extension of mass for jugular-carotid region (level II) consistency increased. A clinical suspicion of glomus was confirmed by computerized tomography scan study contrasted neck, magnetic resonance imaging and Magnetic resonance angiography of the cervical vessels that defined an injury with oval 5X4X6cm, the topography of the right carotid space shifting the external carotid artery and the internal carotid bulb hypervascular region, extending to the parapharyngeal space and suggestive of carotid paraganglioma. The treatment indication was surgical resection without performing previous embolization. The carotid paraganglioma is a rare tumor and growth slow that affects the jugular-carotid region. The parapharyngeal extension is rare and should be in the differential diagnosis of parapharyngeal space (AU)