HomePhilippine Journal of Otolaryngology Head and Neck Surgeryvol. 25 no. 1 (2010)

Parapharyngeal Neurofibroma in a Pediatric Patient

Rubiliza DC Onofre



Primary tumors of the parapharyngeal area are rare and account for 0.5% of all head and neck tumors.1,2 Among these, 80% are benign while 20% are malignant.2 Next to schwannomas, neurofibromas are the second most commonly encountered primary tumor of nerve sheath origin in the parapharyngeal space but incidence and prevalence rates have not been documented among pediatric patients.3,4 Plexiform neurofibromas in particular pose a surgical challenge in pediatric patients. Careful preoperative planning, advanced surgical techniques and vigilant
postoperative care result in minimal morbidity and resolution of tumor symptomatology.5 Although complete surgical resection is ideal for all (especially benign) parapharyngeal tumors,4 the dilemma of complete versus partial resection arises when massive size increases the possibility of neurological dysfunction and cosmetic deformity from damage to adjacent cranial nerves and sympathetic chain fibers.6 We present the management dilemma involving a neurofibroma of the parapharyngeal space in a pediatric patient.