Juvenile nasopharyngeal angiofibroma

The juvenile nasopharyngeal angiofibroma, a locally invasive, non-metastasizing tumour of male adolescence, occurs sporadically throughout the world. Its histiogenesis remains uncertain and its management controversial. These facets of a troublesome and dangerous conditions are discussed and the experiences from handling 9 such tumours seen at Groote Schuur Hospital over a 4-year period (1976-1979) are presented. Surgical excision, using a wide field exposure and pre-operative systemic oestrogen medication, is recommended as the treatment of choice.     

Deafness--a complication of nasopharyngeal airways

We report a patient who developed temporary deafness secondary to oedema of the uvula and soft palate following prolonged continuous positive airway pressure via a nasopharyngeal airway.     

Resection of persistent nasopharyngeal carcinoma

Although radiotherapy has been generally accepted as the treatment of choice for nasopharyngeal carcinoma (NPC), NPC at the primary site is not always controlled by this therapy. We performed surgical treatment to eradicate such residual tumor through a transmandibular, transpterygoid approach, on four patients with local residual NPC after curative radiotherapy. Two patients survived with no evidence of disease for more than 6 years. The other two patients died of multiple metastases to the liver or bone at 4 years and at 6 months after treatment. However, the nasopharynx remained free of disease in these two patients. Although the number of patients in the present series is small, surgical treatment of local persistent tumor after radiotherapy was beneficial. The indication for this technique is tumor in the nasopharynx extending to the parapharyngeal space, not invading intracranially. The transmandibular, transpterygoid approach offers a wide operative field with minimal postoperative morbidity, making it possible to manage the internal carotid artery easily.     

Molecular diagnosis of nasopharyngeal carcinoma: detecting LMP-1 and EBNA by nasopharyngeal swab.

OBJECTIVES: The aim of this study was to investigate the feasibility of molecular diagnosis of nasopharyngeal carcinoma (NPC) by combining nasopharyngeal swab and polymerase chain reaction (PCR) to detect Epstein-Barr virus (EBV) derived latent membrane protein-1 gene (LMP-1) and Epstein-Barr nuclear antigen gene (EBNA). METHODS: 437 adults underwent nasopharyngoscopy, possible biopsy, and nasopharyngeal swab to obtain nasopharyngeal cells for the detection of LMP-1 and EBNA by PCR. RESULTS: By detecting LMP-1 and EBNA in the nasopharyngeal swabs, NPC could be diagnosed with a false-positive rate of 1.7% (6/354), a false-negative rate of 8.6% (6/70), a sensitivity of 91.4% (64/70), a specificity of 98.3% (348/354), positive predictive value of 91.4% (64/70), and negative predictive value of 98.3% (348/354). CONCLUSION: Detecting EBV genomic LMP-1 and EBNA by nasopharyngeal swab verifies NPC with a sensitivity of 91.4% and specificity of 98.3%. The nasopharyngeal swab coupled with PCR based EBV LMP-1 and EBNA detection could serve as a good supplement to pathological diagnosis of NPC.     

Management of nasopharyngeal stenosis after uvulopalatoplasty

OBJECTIVE: The objective of this study is to evaluate the management of nasopharyngeal stenosis (NPS) with the CO(2) laser and a customized nasopharyngeal obturator. Study Design: An 8-year retrospective study based at a tertiary care teaching hospital consisting of 18 patients with NPS after uvulopalatoplasty treated over an 8-year period with the CO(2) laser and a nasopharyngeal obturator. Patients with grade I stenosis were treated in the office and did not require a nasopharyngeal obturator. More severe cases (grades II and III) were treated in the operating room and required a nasopharyngeal obturator. RESULTS: Eighteen patients with NPS, stages I to III, were treated with a CO(2) laser with or without a nasopharyngeal obturator with good results. CONCLUSION: The repair of NPS with a CO(2) laser and a nasopharyngeal obturator in severe cases helps in restoring nasopharyngeal patency. SIGNIFICANCE: This technique provided a reliable method of correcting postuvulopalatoplasty NPS.     

Modern diagnostic procedures of nasopharyngeal carcinoma

The aim of this study is a research of single photon emission tomography (SPET) values with talium 201 and tehnetium 99m MIBI, comparing it with other methods CT, MRI and ultrasonography. In our investigation there were two groups of patients 24 treated with T1-201 and 17 with Tc-99m-MIBI. Before the therapy 7 patients had been tested with T1 201 and was 100% proved the sensibility, specificity, sensitivity and also 6 patients as really positive TP and 1 patient really negative TN. The same result was gotten in the group where TC 99m was used, where 3 of them were really positive and 1 negative. All discoveries were confirmed pathohistologically and leaning on this we determined the status of really positive and really negative patients. After the therapy there were 7 positive and 7 negative patients, and also one positive, and 2 negatives that were false, who were treated by thalium. On the basis of formula of sensibility these findings show that 77,8%, if it observed only a group of patients who were being tested after the therapy, while all sensibility of methode is 86.7%, where in the analise was included a group of patients at whom was registred the primary tumor. The specificity of the method for this group of patients after the therapy is 87.5%, and the whole 88.9% where the accuarsy is 82.4% in the group after therapy and the whole is 87.5%.