Cone-Beam Computed Tomographic Evaluation of the Posterior Wall of the Nasopharynx in Turkish Population

Yıl 2023, Cilt: 5 Sayı: Supplement (1) - Innovations in Medicine and Healthcare in the 100th Year of the Republic, 110 - 5, 19.10.2023

Ceren Özeren Keşkek

https://doi.org/10.37990/medr.1351878

Öz

Aim: This study aims to evaluate the radio-morphometry of important anatomical structures such as Rosenmüller fossa (RF), pharyngeal bursa (PB), and Eustachian tube (ET) in the posterior wall of the nasopharynx by cone beam computed tomography (CBCT).
Material and Methods: The posterior wall of the nasopharynx was analyzed retrospectively in CBCT images of 110 patients. The depth and width of the Rosenmüller fossa (RF), pharyngeal bursa (PB), and Eustachian tube (ET), their distances to the posterior nasal spina (PNS) and mid-sagittal plane, and the angles between them were measured. RF was categorized into three types. The relationship between the measured values and gender, age groups, and RF types was investigated. The obtained variables were analyzed statistically.
Results: The mean right RF depth was 8.2 and left RF was 8.6 mm. RF widths differed significantly by gender (right p=0.013, left p=0.004). There was a statistically significant positive correlation between RF-PNS distances and age (left r=0.314, p=0.001; right r=0.240, p=0.011). The prevalence of RF types was 31.8%, 19.5%, and 48.6% for type A, type B, and type C, respectively. In individuals with RF Type C, both RF and ET were located more lateral to the midline. The prevalence of PB was 45.5%.
Conclusion: Nasopharyngeal carcinoma (NPC) most commonly occurs in the RF. A good knowledge of the anatomy and variations of the nasopharyngeal region is important in the early diagnosis of NPC. Oral and maxillofacial radiologists must know the anatomy of the nasopharynx to understand and interpret incidental findings in CBCT.

Anahtar Kelimeler

Cone-beam computed tomography, Eustachian tube, nasopharynx, nasopharyngeal carcinoma, pharyngeal bursa, Rosenmüller fossa.

Kaynakça

• Kaplan FA, Saglam H, Bilgir E, et al. Radıologıcal evaluatıon of the recesses on the posterıor wall of the nasopharynx wıth cone-beam computed tomography. Niger J Clin Pract. Jan;25:55-61.
• Takasugi Y, Futagawa K, Konishi T, et al. Possible association between successful intubation via the right nostril and anatomical variations of the nasopharynx during nasotracheal intubation: a multiplanar imaging study. J Anesth. 2016;30:987-93.
• Aksakal C. A very rare localization of rhinolith: fossa of rosenmuller. J Craniofac Surg. 2020;31:e113-4.
• Alshuhayb Z, Alkhamis H, Aldossary M, et al. Tornwaldt nasopharyngeal cyst: case series and literature review. Int J Surg Case Rep. 2020;76:166-9.
• Amene C, Cosetti M, Ambekar S, et al. Johann Christian Rosenmüller (1771-1820): a historical perspective on the man behind the fossa. J Neurol Surg B Skull Base. 2013;74:187-93.
• Velayutham P, Davis P, Savery N, Vaigundavasan R. A common symptom with an uncommon diagnosis. The Egyptian Journal of Otolaryngology. 2021;37:95.
• Serindere G, Gunduz K, Avsever H, Orhan K. The anatomical and measurement study of rosenmüller fossa and oropharyngeal structures using cone beam computed tomography. Acta Clin Croat. 2022;61:177-84.
• Erdem Ş, Zengin AZ, Erdem Ş. Evaluation of the pharyngeal recess with cone-beam computed tomography. Surg Radiol Anat. 2020;42:1307-13.
• Temiz M, Duman SB, Abdelkarim AZ, et al. Nasopharynx evaluation in children of unilateral cleft palate patients and normal with cone beam computed tomography. Sci Prog. 2023;106:368504231157146.
• Sutthiprapaporn P, Tanimoto K, Ohtsuka M, et al. Improved inspection of the lateral pharyngeal recess using cone-beam computed tomography in the upright position. Oral Radiology. 2008;24:71-5.
• Erdem H, Tekelİ M, Cevik Y, et al. Quantitative assessment of the pharyngeal recess morphometry in anatolian population using 3D models generated from multidetector computed tomography images. Med Records. 2023;5:507-12.
• Hoe J. CT of nasopharyngeal carcinoma: significance of widening of the preoccipital soft tissue on axial scans. AJR Am J Roentgenol. 1989;153:867-72.
• Hoe JW. Computed tomography of nasopharyngeal carcinoma. A review of CT appearances in 56 patients. Eur J Radiol. 1989;9:83-90.
• Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc. 2006;72:75-80.
• Reiter S, Gavish A, Winocur E, et al. Nasopharyngeal carcinoma mimicking a temporomandibular disorder: a case report. J Orofac Pain. 2006;20:74-81. Erratum in: J Orofac Pain. 2006;20:106.
• Ozyar E, Ebru K, Ferah Y, Atahan İ. Factors related with development of treatment induced trismus in nasopharyngeal cancer patients. Turkish Journal of Oncology. 2006;21:57-62.
• Zubizarreta PA, D'Antonio G, Raslawski E, et al. Nasopharyngeal carcinoma in childhood and adolescence: a single-institution experience with combined therapy. Cancer. 2000;89:690-5.
• Ben Salem D, Duvillard C, Assous D, et al. Imaging of nasopharyngeal cysts and bursae. Eur Radiol. 2006;16:2249-58.