The parapharyngeal space.

A series of 73 lesions presenting in the parapharyngeal space is presented. There were 53 (73 per cent) patients with deep lobe parotid benign or malignant tumours, five (7 per cent) patients with tumours of neurogenous origin, seven (9 per cent) patients with abscesses, five (7 per cent) patients with enlarged lymph nodes, two with branchial cysts, and one with a lipoma. The anatomy emphasizes the expansile nature of the space and also the close proximity of vital structures. The importance of the use of combined CAT scan and sialography is discussed in the diagnosis of these patients. The various prognostic factors are mentioned and a description is given of the best way to approach the parapharyngeal space without damaging the facial nerve. With careful planning and preparation of the planned operation, the morbidity of the facial nerve may be considerably reduced.