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Tumors of the cervical sympathetic chain—Diagnosis and management
Author(s) -
Langerman Alexander,
Rangarajan Sanjeet V.,
Athavale Sanjay M.,
Pham Michelle Q.,
Sinard Robert J.,
Netterville James L.
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23050
Subject(s) - medicine , parapharyngeal space , dysphagia , horner syndrome , neck mass , radiology , differential diagnosis , paraganglioma , throat , neck pain , neurofibroma , carotid arteries , head and neck , carotid body , surgery , pathology , alternative medicine , neurofibromatosis
Background Tumors originating from the cervical sympathetic chain are uncommon but important entities in the differential diagnosis of parapharyngeal space masses. Methods We conducted a retrospective review of patients presenting with tumors of the cervical sympathetic chain. Results Twenty‐four patients presented between 1994 and 2010. Presenting symptoms were dysphagia ( n = 7.29%), neck mass ( n = 7.29%), throat fullness ( n = 4.17%), and Horner syndrome ( n = 2.8%). Although radiologic images showed classic lateral displacement of the carotid arteries in 10 patients (42%), in 9 patients (38%) the radiologic findings demonstrated splaying of the carotid arteries similar to carotid body tumor, and in 5 patients (20%), the findings were indeterminate. Twenty‐one patients underwent surgical removal of the tumors with pathology revealing 10 paragangliomas, 10 schwannomas, and 1 neurofibroma. Horner (57%) and first‐bite (33%) syndromes were the most common complications. Conclusions Although anterolateral displacement of the carotids is suggestive of a sympathetic tumor, absence of these findings does not rule out this entity. To this end, we have included in this review a guide to preoperative radiologic diagnosis of parapharyngeal space lesions. © 2012 Wiley Periodicals, Inc. Head Neck, 2013