Nasopharyngeal amyloidosis is an extremely rare benign tumour. It is divided into localized or systemic amyloidosis. It is more common in men. Clinical presentation includes nasal blockage, epistaxis and reduced hearing. Classical positive Congo red stain and appearance of apple green birefringence on polarized microscopy confirms the diagnosis of amyloidosis. We present a case of nasopharyngeal amyloidosis in a 44-year old lady who presented with acute hearing loss for 1 week with epistaxis mimicking nasopharyngeal carcinoma. Clinical examination showed a nasopharyngeal mass with biopsy proven AA amyloidosis. She is now cured of amyloidosis following endoscopic transnasal excision of tumour. We discuss on the similarity of presentation between nasopharyngeal carcinoma; the commonest malignant tumour in our region and the much rarer nasopharyngeal amyloidosis as well as highlighting the importance in early recognition of the latter in view of its known risk of systemic involvement.
Nasopharynx

Objective: To report a case of extramedullary plasmacytoma, a rare localized tumour involving the head and neck region in a 56-year -old gentleman. Methods: Design: Case Report Setting: Tertiary University Referral Center Patient: One Result: The patient presented with a 5-month history of right-sided nasal obstruction and intermittent epistaxis in 2003. Nasal endoscopy revealed a friable, dark red mass arising from the roof of the nasopharynx, occluding the right choana. No invasion of adjacent tissues or cervical lymphadenopathy was evident. A biopsy of the mass was diagnosed as plasmacytoma. Serum and urine electrophoresis failed to detect any monoclonal bands. All other screening tests to rule out multiple myeloma were negative. These findings confirmed the diagnosis of extramedullary plasmacytoma. He recieved radiotherapy to the nasopharynx of 50 Gy for a total of 23 fractions. No recurrence was noted at 7-year follow-up. Conclusion Extramedullary plasmacytoma of the nasopharynx represents a tumour with good prognosis but requires long term follow up in anticipation of local recurrence and progression to Multiple Myeloma.
Plasmacytoma ; Nasopharynx

Objective: To report successful marsupialization of a large Tornwaldt cyst using combined transnasal and transoral endoscopic surgery in a 7-year-old girl who presented with nasal obstruction. Methods: Design: Case Report Setting: Tertiary Government Training Hospital Patient: One Result: A 7-year-old girl presented with an 11-month history of recurrent yellowish nasal discharge gradually associated with nasal obstruction. Examination revealed a large, well encapsulated, broad-based cystic mass in the nasopharynx immediately adjacent to the posterior choanae, continuing posterior to the soft palate (pushing the uvula anteriorly) and extending inferiorly to the epiglottic area. Computerized Tomography (CT) demonstrated a well-circumscribed, midline hypodense mass with fluid attenuation obstructing the nasopharyngeal area extending inferiorly to the oropharyngeal area. Endoscopic marsupialization via transnasal and transoral approach was successful, and a respiratory epithelium-lined cyst consistent with a Tornwaldt cyst was confirmed by histopathologic examination Conclusion: Combined transnasal and transoral endoscopic marsupialization is possible a for a large symptomatic Tornwaldt cyst in a pediatric patient with relatively smaller and complex nasal cavities.
endoscopy ; cyst ; Nasopharynx ;

Objective: To determine a normative value for the nasopharyngeal depth from the anterior nasal spine (ND-ANS) among normal adult Filipinos using Computed Tomography scans. Methods: Design: Cross-sectional study. Setting: Tertiary National University Hospital. Participants: Of 516 adult patients that underwent facial, neck and temporal bone CT scans in our hospital between January 1 to June 30, 2019, 100 cases were randomized to be included in the study and 91 CT scans were analyzed. Results: The mean nasopharyngeal depth from the anterior nasal spine among Filipino adults is 7.17 ± 0.42. There was a significant difference between sexes with a mean measurement of 7.23 cm ± 0.44 in males and 7.09 ± 0.37 cm in females. There was no statistically significant difference in mean nasopharyngeal depth across age groups. Conclusion A statistically significant difference was observed between sexes in our study sample. Our study provides initial normative values of nasopharyngeal depth among adult Filipinos, and additional studies may use this as a basis for further research.
Nasopharynx ; Adult ; Anthropometry

OBJECTIVE: To report a case of ectopic brain tissue in the nasopharynx; discuss the differential diagnoses for and management of, this unilateral nasal mass in a pediatric patient, and describe the diagnosis difficulties and eventual treatment.

METHODS:
Study Design: Case Report
Setting: Tertiary Government Hospital
Participant: One

RESULTS: A 13-year-old boy consulted with an obstructing mass in the nasopharynx and severe muscle wasting, weight below his age and concurrent anemia. CT-scan revealed a soft-tissue mass occupying a maxillary sinus and nasopharynx consistent with an antrochoanal polyp. Initial biopsy revealed a papilloma, but the clinical picture warranted preoperative preparations for a possible vascular tumor such as juvenile angiofibroma. Transpalatal excision and final histopathology yielded nasal glial heterotopia.

CONCLUSION: When confronted with unilateral nasal mass in a pediatric patient, aside from the usual considerations, embryologic anomalies particularly those of the intracranial protrusion variety should be strongly considered. Scrupulous preoperative evaluation and sufficient diagnostic modalities must be pursued in order to arrive at a correct diagnosis, treatment plan and prevent possible complications especially those related to intracranial communication.

BACKGROUND: The nasopharyngeal temperature probe should be placed in the upper nasopharynx to reflect accurate core temperature. However, there have been no studies conducted to predict parameters for the optimal depth of the nasopharyngeal temperature probe. The purpose of this study was to examine the correlation between the optimal depth to the upper nasopharynx and the distance from the philtrum to the tragus and height. METHODS: Two hundred patients (100 females and 100 males) were enrolled in the study. The distance from the philtrum to the tragus along the facial curvature was measured, and the optimal depth from the nostril to the upper nasopharynx was evaluated using nasendoscopy. The relationships between the optimal depth to the upper nasopharynx and the distance from the philtrum to the tragus and height were examined. RESULTS: The distances from the philtrum to the tragus were 14.4 +/- 0.5 cm in females and 15.1 +/- 0.6 cm in males (P < 0.01). The depths from the nostril to the upper nasopharynx were 9.4 +/- 0.6 cm in females and 10.0 +/- 0.5 cm in males (P < 0.01). The correlation coefficients between the depth from the nostril to the upper nasopharynx and the distance to the tragus from the philtrum were 0.43 in females and 0.41 in males (P < 0.01). However, there were very weak correlations and no correlations between height and the depth from the nostril to the upper nasopharynx in females and males, respectively. CONCLUSIONS: The depth from the nostril to the upper nasopharynx is correlated weakly with the distance from the philtrum to the tragus. Although the distance from the philtrum to the tragus is not a good predicting parameter for the optimal depth of nasopharyngeal temperature probe placement, subtraction of 5 cm from the distance is helpful to estimate the optimal depth of the nasopharyngeal temperature probe.
Anesthesia ; Female ; Humans ; Lip* ; Male ; Nasopharynx

PURPOSE: This retrospective study aimed to evaluate the nasopharyngeal and oropharyngeal dimensions of individuals with skeletal class II, division 1 and division 2 patterns during the pre-peak, peak, and post-peak growth periods for comparison with a skeletal class I control group. MATERIALS AND METHODS: Totally 124 lateral cephalograms (47 for skeletal class I; 45 for skeletal class II, division 1; and 32 for skeletal class II, division 2) in pre-peak, peak, and post-peak growth periods were selected from the department archives. Thirteen landmarks, 4 angular and 4 linear measurements, and 4 proportional calculations were obtained. The ANOVA and Duncan test were applied to compare the differences among the study groups during the growth periods. RESULTS: Statistically significant differences were found between the skeletal class II, division 2 group and other groups for the gonion-gnathion/sella-nasion angle. The sella-nasion-B-point angle was different among the groups, while the A-point-nasion-B-point angle was significantly different for all 3 groups. The nasopharyngeal airway space showed a statistically significant difference among the groups throughout the growth periods. The interaction among the growth periods and study groups was statistically significant regarding the upper oropharyngeal airway space measurement. The lower oropharyngeal airway space measurement showed a statistically significant difference among the groups, with the smallest dimension observed in the skeletal class II, division 2 group. CONCLUSION: The naso-oropharyngeal airway dimensions showed a statistically significant difference among the class II, division 1; class II, division 2; and class I groups during different growth periods.
Cephalometry ; Malocclusion ; Nasopharynx ; Orthodontics ; Retrospective Studies

Lymphoepithelioma-like carcinonma of the skin(LELCS) is a rare tumor with a microscopic resemblance to lymphoepitheliomatous tumors of the nasopharynx. Less than 100 examples of LELCS are having been reported since its initial description in 1988. Elderly patient are preferentially affected, and the skin of the head and neck is the principal location for this neoplasm. We report a 70 year-old male patient who had brownish colored, moderately firm nodule on the left malar area of the face. Histopathologically, the nodule showed features of LELCS and he was treated with excision and local flap coverage.
Aged ; Head ; Humans ; Male ; Nasopharynx ; Neck ; Skin*

BACKGROUND: The insertion of a nasogastric tube can be difficult in an anesthetized patient who has a cuffed endotracheal tube in place. The placement of a silastic nasogastric (NG) tube can lead to nasal bleeding or a submucosal dissection in the posterior pharynx. The aim of this study was to determine if the insertion of a nasogastric tube with a nasophryngeal airway can be made easy. METHODS: Sixty patients were randomly assigned to one of two groups; Group 1 and Group 2. For Group 1, a nasogastric tube was inserted first. If this method was not successful with two consecutive attempts, then a nasogastric tube with a nasopharyngeal airway was inserted and if unsuccessful again with two attempts, then Magill forceps were used under laryngoscopy. For Group 2, a nasogastric tube with a nasopharyngeal airway was inserted first. If this method was not successful with two consecutive attempts, then a nasogastric tube was inserted and if unsuccessful again with two attempts, then Magill forceps were used under laryngoscopy. RESULTS: The success rate of the 1st pass in Group 2 was significantly higher than in Group 1 (P < 0.05). The success rate with the 1st intended method in Group 2 was significantly higher than in Group 1 (P < 0.05). The rate of using Magill forceps was not significantly different between the two groups. CONCLUSIONS: The insertion of a nasogastric tube with a nasopharyngeal airway in anesthetized and intubated patients is effective in increasing success rate of insertion. Nasopharyngeal airway traverses the nasopharynx atraumatically and serves as a conduit for the smaller nasogastric tube.
Epistaxis ; Humans ; Laryngoscopy ; Nasopharynx ; Pharynx ; Surgical Instruments

RTOG proposed a multivariate modeling system predicting the response of head and neck cancers to radiation therapy in 1984. The aim of this study was to verify whether PPC (Probability of primary clearance calculated by a multivariate modeling system) had any correlation with the survival in the patients with carcinoma of the nasopharynx following radiation therapy. Analysing 81 patients with carcinoma of the nasopharynx treated with radiotherapy between January 1, 1971 and December 31, 1983 at Yonsei University College of Medicine, Yonsei Cancer Center, the actuarial 5 year survival rate was 36% and median survival was 39 months. The survivals for Group 1 (27 who had more than 80% of PPC), Group 2 (20 who had between 71 and 80% of PPC), and Group 3 (29 who had less than 71% of PPC) were 66% (median survival months: more than 72), 27% (31), and 4% (12) respectively. There was a definite correlation between PPC and survival among the three groups.
Head ; Humans ; Nasopharynx* ; Neck ; Radiotherapy ; Survival Rate