Parapharyngeal space tumors: Another consideration for otalgia and temporomandibular disorders

Background Parapharyngeal space (PPS) tumors are rare, accounting for 0.5% of all head and neck neoplasms. PPS tumors are difficult to diagnose due to limited presenting signs and symptoms and because of their location deep within the neck. Methods and Results A 60‐year‐old woman presented with complaints of otalgia, which appeared to be consistent with a temporomandibular disorder (TMD). Due to disproportionate symptoms, an MRI of the temporomandibular joints was ordered. The MRI revealed a mass within the PPS, which was later diagnosed as a mucoepidermoid carcinoma. A literature search failed to reveal otalgia, and facial pain, thought to be related to a TMD, as the primary presenting symptoms of a PPS neoplasm. Conclusion Patients presenting with disproportionate signs and symptoms of a TMD should be evaluated with advanced imaging to rule out occult pathology. © 2012 Wiley Periodicals, Inc. Head Neck, 2013