ObjectiveTo investigate the diagnosis and treatment of parapharyngeal space tumors in order to improve the operation level and reduce complications.MethodsClinical data of 58 patients with parapharyngeal space tumors surgically treated via appropriate surgical approaches in our hospital from Jan 2000 to May 2012 were analyzed retrospectively. Surgical approaches fell into the following four kinds: intraoral approach (n=4), lateral cervical approach (n=46), cervical parotid approach (n=6), and infratemporal fossa approach (n=2). For all the 58 patients, postoperative pathological diagnosis of tumors were obtained, postoperative complications were analyzed, longterm followup results of one year, three years and five years were recorded.ResultsIn 31cases underwent preoperative computerized tomography (CT), CT findings were consistent with postoperative pathological results in 24. In 28 patients underwent magnetic resonance imaging (MRI) examination, MRI findings were consistent with postoperative pathological results in 21. Ultrasonic results were in accordance with postoperative pathological diagnosis in 8 of 15 patients receiving Bultrasonic examination. Postoperative pathological examinations confirmed benign tumors in 44 cases (75.86%) and malignant tumors in 14 (24.14%). In terms of pathological types, schwannoma accounted for the highest percentage. Postoperative complications included infection, hemorrhage, vagus nerve injury, vocal cord paralysis, salivary fistula, peripheral facial paralysis, glossopharyngeal nerve paralysis and Horner syndrome. Complications were more common in the patients surgically treated via intraoral approach and cervical parotid approach. Local recurrence occurred in one patient with benign tumor resected via intraoral approach, and no recurrence was detected after the second operation. Of the 44 patients with benign tumors, no one died of tumor within 3 years and 5 years. Of the 14 cases with malignant tumors, recurrence occurred in 6, one was lost to followup, with 1year, 3year, and 5year mortality rates of 14.29%（2/14），28.57%（4/14），and 42.86%（6/14）.ConclusionsPreoperative imaging examinations are very important for diagnosis of parapharyngeal tumor. Selection of appropriate surgical approach is critical for operation. With advantages of fewer complications and significant therapeutic effect, lateral cervical approach is effective and the most common for resection of parapharyngeal tumor, and therefore worth clinical promotion.