Objective To explore the clinical features of primary parapharyngeal space (PPS) tumors.

Methods The case data of 30 patients with primary PPS tumors admitted to Zhongshan Hospital, Fudan University from March 2010 to August 2018 were retrospectively selected, and their symptoms, signs, CT and MRI manifestations, surgical approaches, postoperative pathology and complications were analyzed.

Results There were 13 males and 17 females, aged 22-78 years, with an average age of (44.3±15.4) years. 21 patients showed no obvious symptoms and sought medical attention due to the discovery of a neck lump. CT/MRI findings of schwannoma, pleomorphic adenoma, paraganglioma and other types of tumors can effectively show the size and location of the tumor and its relationship with surrounding tissues. All 30 patients underwent surgical resection of the tumor, of which 26 underwent a cervical approach. The pathological results showed 29 cases of benign tumors, including 13 cases of schwannoma and 10 cases of pleomorphic adenoma. Postoperative vocal cord paralysis occurred in 4 cases, Horner's syndrome in 3 cases, facial paralysis in 2 cases, tongue deviation in 1 case, and difficulty lifting the shoulder in 1 case. There was no recurrence or metastasis in the follow-up patients.

Conclusion Most PPS tumor patients have no obvious symptoms. CT/MRI is helpful for diagnosis and selection of surgical approach. Schwannoma and pleomorphic adenoma are the most common pathological types.