Parapharyngeal space masses: an updated protocol based upon 104 cases.

TLDR

The study presents an updated CT protocol for diagnosing parapharyngeal space masses and addresses challenges in differential diagnosis. The protocol employs dynamic CT scanning to provide preoperative diagnosis, largely eliminating the need for angiography or digital venous imaging. The updated protocol achieved an 88 % preoperative diagnostic rate, allowed virtually all cases to reach a limited differential diagnosis, largely obviated angiography or digital venous imaging, and provided evidence that minor salivary gland benign mixed tumors may originate from salivary rest tissue rather than pharyngeal mucosal glands.

Abstract

Surgical and CT examinations of 104 patients, each of whom presented with a parapharyngeal space mass, has resulted in the development of an updated CT protocol designed to provide a preoperative diagnosis. When dynamic scanning is used, diagnostic angiography or digital venous imaging (DVI) can be avoided in almost all of these cases. A specific preoperative diagnosis can be made in 88% of the patients and a limited differential diagnosis, which includes the final diagnosis, can be made in virtually all cases. The protocol and the problems encountered in differential diagnosis are presented. Evidence to suggest that minor salivary gland benign mixed tumors may arise in salivary rest tissue, rather than pharyngeal mucosal glands, is also presented.