Study On Relationship Between Pathological Type And Imaging And Clinical Characteristics Of Parapharyngeal Space Tumour

OBJECTIVE: To summarize the imaging and clinical manifestations of different pathological types of parapharyngeal space tumors,and to provide a basis for more accurate preoperative diagnosis and evaluation,and to provide assistance for treatment Methods:From January 2012 to October 2018,the clinical data of 106 patients with parapharyngeal space tumors were retrospectively analyzed,including 44 males and 62 females,aged from 3 days to 40 years,with an average age of 49.88±14.79 years.There were 97 cases of 106 parapharyngeal tumors in this group,including 79 CT plain scan+enhancement,4 CT plain scan and 52 MRI plain scan.There were 9 cases of lost access to imaging data.This study mainly compares the(1)clinical data related to benign and malignant tumors;(2)Clinical data related to salivary adenogenic tumors;(3)Clinical data related to neurosheath tumor;(4)Clinical data related to paraganglioma;(5)Clinical data of tumor from anterior and posterior gaps;Statistical analysis and discussion of related issues shall be carried out.Results:The highest age of parapharyngeal space tumors was 40 ? 60 years old.After comparison,it was found that the pathological classification,clinical manifestations and imaging features were as follows:(1)benign tumors were more common in women than malignant tumors,and the boundary of tumors was clear,and there was significant difference between benign and malignant tumors.(2)malignant tumors were more common in men than benign tumors,with enlarged lymph nodes and nerve-related manifestations,and the probability of masses wrapped around the internal / external carotid artery was higher.There was significant difference between benign and malignant tumors.(3)the positive clinical manifestations of salivary gland tumors were less,the boundary was unclear,protruding into the pharyngeal cavity,the maximum transverse diameter was oral pharynx,and it was not easy to wrap around the internal / external carotid artery and make the neck inside.There were significant differences in external artery displacement,salivary gland tumors and non-salivary tumors.(4)in the imaging of schwannoma,the boundary is more clear,which is located in the posterior styloid space,which is not closely related to the parotid gland,does not wrap around the internal / external carotid artery,and has a high incidence of empty flow.There was significant difference between schwannoma and non-schwannoma.(5)paraganglioma had more positive clinical manifestations and local compression symptoms than non-paraganglioma,which was not closely related to parotitis and wrapped around the internal / external carotid artery.The distance of internal and external carotid artery widened,the displacement of internal and external carotid artery,the appearance of vascular flow empty shadow,the maximum diameter of skull base / laryngopharynx,not protruding into pharyngeal cavity,no displacement of styloid process,the incidence of bilateral high.There was significant difference between paraganglioma and non-paraganglioma.6 the tumor in the anterior styloid space is more likely to protrude into the pharyngeal cavity than the tumor in the posterior styloid space,and it is more difficult to wrap around the internal / external carotid artery and widen the distance between the internal and external carotid artery.The incidence of displacement of internal / external cervical artery was higher,and there was significant difference between tumors before styloid process and posterior space.Conclusions: Parapharyngeal space tumors are mostly paragangliomas,followed by neurosheath tumors,most of which are middle-aged and elderly patients.Local compression is the most common clinical manifestation.Salivary gland tumors occur in the anterior space of styloid process,and internal/external carotid artery can shift backward.The boundary of neurosheath tumor is clear,and the cervical vascular displacement of tumors from different nerve sources has its own characteristics.Paragangliomas all show local compression,glomus jugulare tumor is more prone to nerve involvement symptoms,and different types of paragangliomas have different patterns of vascular displacement direction.Correct understanding and mastering of the rules are helpful for preoperative evaluation of parapharyngeal space and determination of management.