Purpose Parapharyngeal space neoplasms (PSNs) are rare tumors of the head and neck region. In this study, we report our institutional experience with PSNs over a 27-years period. Methods Patients treated between 1992 and 2018 were identified through our tumor board database. Data concerning demographics, clinical presentation, disease features, treatment, complications and follow-up were obtained retrospectively. Results In total, 48 patients were identified. Most patients had benign tumors (67.5%), with pleomorphic adenoma and schwannoma being the most frequent entities. Malignant tumors represented the remaining 32.5% of neoplasms. Concerning tissue of origin, 67.5% of neoplasms originated from salivary glands and 17.5% were neurogenic. The vast majority of PSNs required open surgical approaches (77%). The most frequent reversible and irreversible complications included paralysis of facial, vagal, and hypoglossal nerves (transient 62.5%, permanent 31.3%). Tumor recurrences occurred in 16.7% of our patients. Conclusion Neoplasms of the parapharyngeal space (PPS) are rare. In our series, consistent with the literature, most patients had benign tumors. Fine-needle aspiration cytology (FNAC) and/or transoral biopsy in selected cases combined with radiographic imaging are helpful to plan the optimal approach (open/transoral) and extent of primary surgery. Close follow-up in malignant neoplasms is crucial to assess recurrence early. We present one of the largest recent studies on PPS tumors treated in a center. Given the low incidence of these tumors, our results contribute to the existing sparse evidence regarding the management and outcome of such tumors.

Background Parotid gland tumors are mostly benign with good prognosis. On the other hand, malignant tumors of the parotid gland often have poor prognosis and metastasize. Mucoepidermoid carcinoma is the most common cancer in the parotid gland accounting for nearly 40–50% of the cases. Therefore, it is important to define the role of fine needle aspiration in differentiating between different types of parotid malignancies. Method This is a retrospective chart review study that was done on 49 consecutive patients who underwent parotid surgeries in King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia, between Jan 2003 and Feb 2020. The records of 49 patients were obtained, fine needle aspiration and pathology reports were reviewed to define the role of fine needle aspiration in diagnosing malignant parotid tumors by calculating the sensitivity, specificity, positive predictive value, and negative predictive value. Results Retrospective analysis of 39 cases revealed that there was one case which was diagnosed for cancer was missed by fine needle aspiration. Meanwhile, six cases were diagnosed as malignant lesions using both fine needle aspiration and histopathology. Furthermore, 30 cases were determined benign based on fine needle aspiration and histopathology. The sensitivity of fine needle aspiration for detecting malignancy was 85.7%, specificity was 93.8%. positive predictive value of 75% and negative predictive value of 96.7%. Conclusion Fine needle aspiration is highly sensitive and specific for parotid tumors. We support the role of pre-operative FNA for all parotid tumors as its accurate in differentiating between benign and malignant lesions.

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Although retropharyngeal abscess is not a common condition, it can impact the quality of life of the affected patients, and can even be life-threatening. Asphyxia, upper respiratory tract obstruction, and respiratory distress might then develop secondary to this abscess which continues to grow even larger increasing the seriousness of the complications. Surgical incisions and long-course medical and antibiotic therapies have been described in the literature for the management of retropharyngeal abscess. In this study, the literature review discusses the surgical and medical treatment of retropharyngeal abscesses and the predicted prognosis of the disease after treatment based on evidence obtained from studies in the literature. Early presentation and management are important in achieving better outcomes and enhancing the prognosis. Therefore, patients should be aware enough of the symptoms that might suggest the presence of a retropharyngeal abscess. Using intravenous antibiotics can achieve favorable outcomes. However, some adverse events might be associated and the treatment might not be completed as a result of reduced patient compliance. Surgical management is also efficacious and can be done by different approaches as discussed earlier. Nevertheless, it can also be associated with some complications. Therefore, providing optimal care for these patients should be considered in all scenarios to enhance the prognosis.