Best of five
- A. Deep-lobe parotid tumour
- B. Vagal schwannoma
- C. Carotid-body paraganglioma
- D. Sympathetic-chain schwannoma
- E. Branchial cyst
FRCS (ORL-HNS) · SECTION 1 SBA
Parapharyngeal space displacement
MRI shows a prestyloid parapharyngeal mass displacing the internal carotid artery posteriorly and widening the stylomandibular tunnel. What origin is most likely?
A. Deep-lobe parotid tumour
Prestyloid lesions commonly arise from salivary tissue; connection through the stylomandibular tunnel and posterior carotid displacement support deep-lobe parotid origin.
Why every option is right or wrong
A. Deep-lobe parotid tumour: Prestyloid lesions commonly arise from salivary tissue; connection through the stylomandibular tunnel and posterior carotid displacement support deep-lobe parotid origin.
B. Vagal schwannoma: A poststyloid vagal lesion typically separates the carotid artery and jugular vein.
C. Carotid-body paraganglioma: This characteristically splays the internal and external carotid arteries.
D. Sympathetic-chain schwannoma: This displaces carotid and jugular structures together without separating them.
E. Branchial cyst: It does not usually extend through the stylomandibular tunnel from the parotid.
What if the scenario changed?
If the mass splayed the carotid bifurcation with salt-and-pepper enhancement, carotid-body paraganglioma would be favoured.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for current guidance, local policy and specialist judgement.
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