A rare case of a glass fragment impacted in the parapharyngeal space associated with neurovascular compromise

Abstract

It is rare for foreign bodies to be found in the parapharyngeal space due to the protection of the mandibular ramus and zygomatic bone. The authors describe a rare case of a patient with an unusual penetrating neck injury caused by broken windshield glass in a traffic accident, which lodged in the parapharyngeal space and punctured the internal jugular vein and cranial nerves. 3 weeks later, a delayed exploration was performed on the patient after detailed evaluation of the relationship between the foreign body and the great vessels. The authors removed the glass fragment easily with no active bleeding because it had been surrounded by a fibrous envelope. This experience indicates that increasing the duration of foreign body retention in the parapharyngeal space may be helpful, allowing fibrosis to surround the foreign body, reducing the risk of active bleeding when it is removed.