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

Thornwaldt's cyst is a rare benign developmental lesion induced by persistent notocord remnants within the midline nasopharynx. Although most patients with the cyst are symptom-free, inflammation or an abscess can develop. Treatment involves excision or wide marsupialization of the cyst. In previous reports, the cysts have been removed transorally by adenoid currette, scissors, and so on. But recently by introduction of nasal endoscopy and its extended application, transnasal approach using nasal endoscopy becomes useful surgical approach to nasopharynx. We report a case of Thornwaldt's cyst which was successfully removed with nasal endoscopy in a 30-year-old man.
Abscess ; Adenoids ; Adult ; Endoscopy* ; Humans ; Inflammation ; 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

The purpose of this study was to evaluate the growth pattern of nasopharyx and adenoid and to obtain useful measurements for evaluating the fuction of the nasal breathing. The biennial serial cephalometric radiographs of 33 samples(19 male, 14 female) with normal occlusion from 8.5 years to 18.5 years of age were used in this study. The distances, areas and ratios on nasopharynx and adenoid were measured and analyzed in each age and sex. The results of this study might be summarized as follows; 1. The mean value and standard deviation of each measurement was obtained in each age and sex. 2. The nasopharyngeal height and the nasopharyngeal depth increased significantly by 14.5 years of age in male and 12.5 years of age in female(p<0.05). 3. The relative nasal airway area showed the minimal value at 8.5 years of age and showed significant increase from 10.5 years to 12.5 years of age in male and from 12.5 years to 14.5 years of age in female(p<0.05). 4. In the correlation analysis between the measurements on the nasal airway and the measurement of relative nasal airway area, the measurements of Ad2-PNS, Ad2-PNS/Ho'-PNS and Upper pharynx appeared singnificant correlation with the measurement of relative nasal airway area(p<0.01).
Adenoids* ; Humans ; Longitudinal Studies* ; Male ; Nasopharynx* ; Pharynx ; Respiration

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

BACKGROUND AND OBJECTIVES: Adenoid vegetation can induce chronic rhinosinusitis in children by obstruction of the nasopharynx or as a reservoir for bacteria. The aim of this study is to determine the efficacy of adenoidectomy in chronic pediatric rhinosinusitis. Materials and Methods: Symptoms of chronic rhinosinusitis were evaluated in 17 patients who underwent an adenoidectomy between November 2001 and July 2002. Patients' age ranged from 4 to 11 years old. Caregivers of the patients were asked about symptoms of chronic rhinosinusitis, which were nasal obstruction, rhinorrhea, postnasal drainage, headache, cough and sputum, by a 10-graded visual analogue scale of 6 items at preoperative and postoperative 2, 3, 4, 5, 6, 8, 10 and 12 weeks, respectively. We assessed the grades of plain radiographic (Waters' view) findings at postoperative 1, 2 and 3 months consecutively. RESULTS: Symptoms of chronic rhinosinusitis were significantly improved following adenoidectomy. Significant improvement of symptom scores began at postoperative 2 weeks on the average. Plain radiographic findings were significantly improved at postoperative 1 month. After postoperative 7 months, 'Cure' was reported in 9 (53%) of 17 patients. Conclusions: In majority of cases, symptoms and radiographic findings of chronic rhinosinusitis in children are improved by adenoidectomy. Adenoidectomy should be considered as a first-line surgical option for pediatric chronic rhino-sinusitis.
Adenoidectomy* ; Adenoids ; Bacteria ; Caregivers ; Child ; Drainage ; Headache Disorders, Primary ; Humans ; Nasal Obstruction ; Nasopharynx ; Sputum

BACKGROUND AND OBJECTIVES: Obliteration of the nasopharynx by adenoid hypertrophy is the primary indication for adenoidectomy. For the documentation of nasopharyngeal adenoid tissue, various methods including radiological, aerodynamic diagnostic modalities have been utilized but are not practically effecient. The authors aimed to investigate the correlation between the shortest A-P diameter of nasopharynx in the preoperative skull lateral view and the postoperative symptom improvement and to establish the criteria for selecting adenoidectomy candidates. MATERIALS AND METHOD: We have evaluated the data from 79 children (50 males, 29 females; age range 4-14 years, mean 6.7 years), who received adenoidectomy with or without tonsillectomy by a single surgeon (senior author) from Jan. 1996 through Dec. 1996. RESULTS: The subjective symptom improvement of the nasal obstruction and snoring was more significantly remarkable in the children whose shortest A-P diameter of nasopharyngeal air-space in skull lateral view was less than 6 mm than that of the children with diameter greater than 6 mm. The subjective symptom improvement did not significantly differ with the accompaniment of palatine tonsillectomy. CONCLUSION: The simple skull lateral X-ray is useful in predicting the subjective symptom improvement and the "cut-off" value of the shortest A-P diameter of nasopharyngeal air-space would be close to 6 mm.
Adenoidectomy* ; Adenoids ; Child ; Female ; Humans ; Hypertrophy ; Male ; Nasal Obstruction ; Nasopharynx ; Skull* ; Snoring ; Tonsillectomy

Reduced nasal breathing can influence the growth and development of facial structures. It may have many causes, and enlarged adenoid is the most frequent one. To investigate the effects of adenoids to jaw growth, we must first understand the normal growth of adenoids and jaws, and the relationship between size of adenoids and the values for the jaw variables. The purpose of this study is to present a more objective standard of nasopharyngeal size and jaw dimension at each bone age, by using Cervical Vertebrae Maturation Index(CVMI) of Hassel, from normal occlusion children aged 6 to 17. The results of this study suggests as follows: 1. At same bone age, female's chronologic age was about 2 year older than male. 2. There was a growth peak of nasopharyngeal(NP) height and depth between CVMI 1 to 2 in male, but in female NP height and depth gradually increase through CVMI 1 to 6. 3. Relative airway of nasopharynx increases the most between CVMI 1 to 2 period in both gender. 4. Among adenoid measurements, Ad2-related variables and upper pharynx, and among dentofacial measurements intercanine width in both arch, maxillary intermolar width and palatal depth had high correlation coefficient with adenoid percentage.
Adenoids* ; Cervical Vertebrae ; Child* ; Child, Preschool ; Female ; Growth and Development ; Humans ; Jaw* ; Male ; Nasopharynx ; Pharynx ; Respiration

Castleman's disease, a benign lymphoproliferative disease of unknown etiology, rarely occurs as a nasopharyngeal mass. Instead, thedisease may appear as a local or generalized tumor-like condition, usually in the mediastinum, andit can also involve both the lymph nodes and non nodal tissue. Since the nasopharyngeal roof is the residence of the pharyngeal tonsil (adenoids), which is rich in lymphoid tissue, the appearance of Castleman's disease is predictable. The presentation is variable and diagnosis is not easy. It may present as an asymptomatic involvement of one lymph node group or as a multicentric disease with systemic feature. Here, we report a 34 year old female patient with histopathologically proven hyaline-vascular type of Castleman's disease, who presented with nasopharyngeal mass and was treated with a complete excision without complication.
Adenoids ; Female ; Giant Lymph Node Hyperplasia ; Humans ; Lymph Nodes ; Lymphoid Tissue ; Mediastinum ; Nasopharynx