Parapharyngeal space tumors: surgical approaches in a series of 13 cases

(a) MRI showing a well-defined PPS tumor (pleomorphic adenoma). (b) Intraoperative view of the transcervical approach. The tumor just before removal. (c) Intraoperative view after tumor removal.

(a) MRI showing a very large PPS tumor (pleomorphic adenoma) which almost obstructs the oropharynx. (b) Intraoperative view of the transmandibular approach. The paramedian and the vertical subsigmoid mandibular osteotomies are demonstrated. (c) The tumor just before removal. (d) The two osteotomies after osteosyntheses with mini-plates.

(a) Digital angiogram showing an intensely vascular PPS tumour (vagal paraganglioma) in close relation to the internal carotid artery. (b) Intraoperative view of the paramedian mandibular osteotomy. (c) After the swing of the mandible, the PPS is exposed. The tumour just before removal. (d) The osteotomy after osteosynthesis with mini-plates.