Pathologic Evaluation of Routine Nasopharynx Punch Biopsy in the Adult Population: Is It Really Necessary?

OBJECTIVES: To retrospectively evaluate the patients who underwent nasopharyngeal biopsy with imaging and biopsy results, who have or don’t have symptoms for nasopharyngeal pathology and to determine the ratio of the nasopharyngeal cancer cases and other pathologic conditions. METHODS: In this retrospective study, 983 patients who underwent endoscopic nasopharyngeal biopsy for symptomatic nasopharyngeal lesions were included. All pathological results, benign or malign was recorded and classified due to the patients’ presenting symptoms such as symptomatic for nasopharyngeal pathology or asymptomatic. Computed tomography (CT) or magnetic resonance imaging (MRI) reports were also recorded separately as group A for malignancy or group B for not malignancy. RESULTS: Forty-five (4.6%) of 983 biopsies were malignant. In this group, there is no statistically significant difference between symptomatic and asymptomatic group. For malignant pathologies, the sensitivity of MRI was found 88.2% and CT was 61.5%. CONCLUSION: For early diagnosis of nasopharyngeal cancer, all patients admitted to Ear, Nose and Throat (ENT) referral clinics should be examined endoscopically irrespective of their complaints and suspicious cases should be investigated by imaging especially by MRI. If MRI report clearly indicates Thornwaldt cyst or reactive lymphoid hyperplasia and this result is compatible with endoscopic findings, biopsy may not be necessary. Apart from these cases, all suspected lesions should be biopsied.

detection of eagle's syndrome with three-dimensional multidetector computerized tomography [CT]

Eagle's Syndrome is caused by elongation of the styloid process or ossification of the stylohyoid ligament. We aimed to evaluate the contribution of 3-Dimensional Multidetector CT findings on Eagle's syndrome. Three-Dimensional Multidetector CT were performed on 13 patients with Eagle's syndrome. Maximum intensity projection [MIP] and volume rendering [VR] images having optimal resolution in all patients were obtained using 3D reconstructions on work-station. Styloid process and its extension, and stylohyoid ligament were evaluated. A styloid processes e"3cm were accepted to be longer than normal. We also had a control group of patients which consisted of ten patients who had no complaints of dysphagia, throat pain, or foreign body sensation in the throat. Elongation of the styloid process was revealed by 3D VR imaging in all patients. We found elongated styloid process bilaterally in two patients. Elongation of the styloid process was clearly revealed by 3D VR imaging in high contrast and spatial resolution under the anatomic orientation like conventional X-ray in all patients. The diagnosis of Eagle's syndrome was confirmed surgically in four of 13 patients. We conclude that 3D VR imaging is a valuable diagnostic method in detecting elongated styloid process