Parapharyngeal Space Tumour Excision

The parapharyngeal space (PPS) is a triangular, fat-filled compartment of the suprahyoid neck, lateral to the pharynx. The PPS has also been termed the peripharyngeal space, pterygopharyngeal space, pterygomandibular space, pterygomaxillary space, pharyngomaxillary space, or the lateral pharyngeal space, but currently, these terms have been discarded in favour of the term parapharyngeal space. The PPS is described as an inverted pyramid with the floor of the pyramid at the skull base and the apex at the level of the greater cornu of the hyoid bone [1–5]. The styloid process, along with the attaching muscles and tensor veli palatini fascia, divides the PPS into prestyloid and poststyloid compartments. The prestyloid space contains the deep lobe of the parotid, minor salivary glands, and fat. The poststyloid space contains the ninth, tenth, eleventh, and twelfth cranial nerves, the cervical sympathetic chain, the internal jugular vein, the internal carotid artery, and lymph nodes (Fig. 22.1).