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  • Title: Tumors of the cervical sympathetic chain--diagnosis and management.
    Author: Langerman A, Rangarajan SV, Athavale SM, Pham MQ, Sinard RJ, Netterville JL.
    Journal: Head Neck; 2013 Jul; 35(7):930-3. PubMed ID: 23002012.
    Abstract:
    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.
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