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Author: admin, 06.03.2014
Figure 3a: Axial unenhanced T1-weighted spin-echo MR image obtained at nasopharynx level, shows fat-filled prestyloid parapharyngeal space (asterisks) located between masticator space and pharyngeal mucosal space.
Figure 3b: Axial unenhanced T1-weighted spin-echo MR image obtained at oropharynx level, shows that parotid space containing parotid gland forms posterolateral boundary of parapharyngeal space (asterisks), and retropharyngeal space and prevertebral space form posteromedial boundary of parapharyngeal space (asterisks). Figure 3c: Coronal unenhanced T1-weighted spin-echo MR image shows continuity of prestyloid parapharyngeal space (asterisks) with submandibular space. The superior border (base) is a portion of the temporal bone lateral to the attachment of the pharyngo-basilar fascia and medial to foramen ovale and spinosum. The inferior border (apex) is described at the junction of the posterior belly of the digastric muscle and greater cornu of the hyoid bone (5). The medial border is formed by the buccopharyngeal fascia over the pharyngobasilar fascia and the pharyngeal constrictor muscles (3). The lateral border is formed by the superficial layer of the deep cervical fascia over the masticator space and the deep lobe of the parotid (3). The posterior border is the prevertebral fascia that covers the spinal column and paraspinal muscles (3). The tensor vascular styloid fascia is a fascial layer that divides the PPS into prestyloid and retrostyloid compartments.
This fascial plane is used as a surgical landmark with the major vessels and cranial nerve laying deep to it. Radiology has an important role in the diagnosis and treatment planning of such lesions (Figure 3). Imaging is an indispensible tool in the investigation of PPS and its different pathologies. Pleomorphic adenomas account for 70-80% of benign salivary gland tumours and are especially common in theparotid gland. The sites of lymph node metastasis of papillary thyroid carcinomas are typically the paratracheal and jugular lymph nodes. Second common type is the carotid body tumor (Figure 12) which originates from the carotid body cells near the carotid bifurcation. They cause characteristic splaying of internal carotid artery (ICA) and external carotid artery (ECA) when located in the crux of carotid bifurcation. Third type is glomus jugulare tumors which arise from the paraganglionic cells around the jugular ganglion.


Dynamic contrast enhanced MRI shows a hypervascular curve with a sharp early filling peak and a rapid washout phase.
These schwannomas show typical anteromedial displacement of the internal carotid artery and lateral displacement with compression of the internal jugular vein.
These cysts are located deep to the tonsillar fossa in the medial aspect of the PPS and just anterior to retropharyngeal space.
Obliteration of the parapharyngeal space fat plane is also frequently associated with infections of the masticator space. The pharyngeal tonsil and submandibular gland can be another source of infection involving the parapharyngeal space. The presence of characteristic peripheral rim calcification with non visualization of internal carotid artery (ICA) separately is adequate for identification of aneurysm (12). Fat suppressed T1-weighted is the single best MRI sequence for diagnosis of dissection (17). 2 clicks for more privacy: On the first click the button will be activated and you can then share the poster with a second click. 6: Myoepithelioma of a minor salivary gland in 22-year-old man with left submandibular mass. BS = buccal space, ICA = internal carotid artery, IJV = internal jugular vein, MS = masticator space, PMS = pharyngeal mucosal space, PPS = parapharyngeal space, PVS = pre-vertebral space, SMS = submandibular space, T = torus tubarius.
Poststyloid parapharyngeal space containing major neurovascular bundle of internal carotid artery and internal jugular vein is located posteriorly.
Cervical MRI: (A) Axial T1-weighted image and (B) Sagittal T1-weighted image show an oval mass in prestyloid compartment of the left parapharyngeal space. Contrast-enhanced CT scan: (A) Axial, (B) coronal, (C) sagittal, show inhomogeneously enhancing mass in left prestyloid parapharyngeal space.
Cervical MRI: (a, b) Axial unenhanced T1-weighted images show lowsignal-intensity mass involving left masticator, parotid and parapharyngeal spaces.
Cervical MRI: (B) Axial and (C) coronal fat saturated T2-weighted images show an elongated mass at the skull base extending from the jugular foramen to retrostyloid parapharyngeal space displacing the internal carotid artery anteriorly.




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