Secret Window to the Parapharyngeal Space: The Transcervical Transdigastric Approach

Ab s t r Ac t Aim: To highlight the transcervical transdigastric approach to the parapharyngeal space. Background: The parapharyngeal space (PPS) contains important neurovascular structures and hence requires meticulous dissection when working with tumors in this space. Surgical access to this blind space is limited, and approach would depend on several factors such as location and extension of tumor, fine needle aspiration cytology (FNAC) report if available, as well as surgeon’s preference and experience. There are limited publications describing the transcervical transdigastric approach to tumors in the PPS. Case description: We present two cases of tumor in the PPS that were addressed using the transcervical transdigastric approach. One patient presented with a painless submental mass, while the other had incidental finding of a PPS tumor on computed tomography scan. Both tumors were histologically benign. Conclusion: The transcervical transdigastric approach to the PPS gives adequate exposure to the surgical field of interest and enables complete excision of well-encapsulated PPS tumors. Clinical significance: The transcervical transdigastric approach allows access to the PPS without aggressive dissection, therefore, avoiding the potential morbidity associated with PPS tumor resection.