Parapharyngeal Space Anatomy and Clinical Importance

Parapharyngeal space

This article is mainly intedend for use by medical professionals.

Parapharyngeal space (PPS) is a potential space filled with fat and areolar tissue, lying laterally on either side of pharynx, bounded and subdivided by various condensation of fascia. It is also known as Pterygopharyngeal, Pterygomaxillary, Pharyngomaxillary and Lateral pharyngeal space.

It is an inverted pyramidal shaped space.

  • The apex of the space is at hyoid bone below (fascia surrounding submandibular gland).
  • The base is at the skull base and tympanic tube above.
  • Medial boundary as pharyngo-basillar fascia and superior constrictor muscle.
  • Laterally by medial pterygoid muscle, mandibular ramus, parotid gland and parotid fascia.
  • Posterior boundary consists of prevertebral structures.
Contents of parapharyngeal space
Contents of parapharyngeal space – Mas: Masseter, MPt: Medial Pterygoid, Scm: Sternocleidomastoid, P: Parotid, Di: Digastric

Styloid process with its muscles and condensation of fascia divides the space into a pre-styolid (anterior compartment) and a post-styloid (posterior compartment). More accurately the division is by tensor palati fascial layer.

  • Pre-styloid/Anterior compartment
    • Apex is at hyoid bone.
    • Main contents include pterygoid, tensor palati muscle, fat, deep lobe of parotid.
    • Communicates with masticator space.
  • Post-styloid
    • Continues low into neck.
    • Lies posterior and medial to prestyloid compartment.
    • Contains carotid sheath (carotid artery, Internal Jugular Vein, Vagus nerve), sympathetic trunk, Cranial nerves IX, X, XII, Major part of Internal Maxillary Artery (IMAX), branches of maxillary nerves and some lymphnodes.

Applied Anatomy of parapharyngeal space


Dr. Sanu. P. Moideen, MBBS, MS (ENT), DNB (ENT), FHNOS, is an otolaryngologist (ENT surgeon), head and neck oncosurgeon practising in Muvattupuzha, Kerala, India. After finishing his postgraduate training, he pursued specialist training in paediatric ENT and head and neck oncosurgery from eminent institutions in India and the US.

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