Parapharyngeal Neuroglial Heterotopia: A Case Report and Literature Review

Patient: Female, 6-month-old Final Diagnosis: Parapharyngeal neuroglial heterotopia Symptoms: Facial swelling • failure to thrive • nasal obstruction • snoring Medication: — Clinical Procedure: — Specialty: Otolaryngology • Pediatrics and Neonatology OBJECTIVE: Rare disease BACKGROUND: Pediatric neck masses have a wide differential diagnosis. Neuroglial heterotopia is a rare condition that was first described by Reid in 1852. The majority of neuroglial heterotopias are found in the nasal cavity (mistakenly termed as nasal glioma), but they can also occur in extra-nasal areas such as the scalp, orbit, palate, neck, and other areas. Only 20 cases of neuroglial heterotopia in the parapharyngeal space have been reported. CASE REPORT: In this case report, we present a 6-month-old girl who was misdiagnosed with unilateral choanal atresia at 1 month of age. As her symptoms progressed to airway obstruction and the size of her neck mass increased, she eventually required surgical management. The pathological diagnosis confirmed a rare case of parapharyngeal neuroglial heterotopia. CONCLUSIONS: Neuroglial heterotopias is one of the differential diagnoses for masses causing airway obstruction in pediatric age groups. Preoperative diagnoses of parapharyngeal neuroglial heterotopias can be challenging, as they have no confirmed specific clinical or radiological features. This paper contributes to parapharyngeal neuroglial heterotopia research, which will ultimately enable clinicians to ascertain these tumors’ characteristic features more promptly for earlier diagnoses.