Contemporary Management of Parapharyngeal Tumors.

PURPOSE OF REVIEW: Management of parapharyngeal tumors is challenging due to the complex anatomic nature of the space and the wide range of pathologies encountered. This article will review the anatomy, common pathologies, and management of parapharyngeal masses. Surgical strategies are also reviewed.

RECENT FINDINGS: Masses of the parapharyngeal space are most commonly benign (80%). More recent longitudinal studies have shown that observation and non-surgical therapy are indicated in many cases. When surgery is indicated, innovative endoscopic and robotic-assisted techniques allow for improved visualization and complete tumor removal while avoiding significant blood loss, tumor spillage, and injury to surrounding nerves and vessels. Management of parapharyngeal masses should consider morbidity of surgical resection versus the natural course of the disease. Surgical strategy is determined by location, size, and pathology. Adequate access is needed surgically to ensure complete resection and avoid tumor rupture.