Aim: This study aims to determine the age interval for which the flexible nasopharyngoscopy (FNP) and lateral nasopharyngeal X-ray radiography (LNX) used in the diagnosis of adenoid hypertrophy more effectively in a pediatric population.
Study Design: Prospective Cohort Study.
Materials and Methods: 281 pediatric patients (1 to 15 years old) who were admitted to our ENT outpatient clinic with the complaints of nasal obstruction, snoring, sleep apnea through April 2016 and February 2017 and who were examined with FNP with the pre-diagnosis of adenoid hypertrophy were included in our study. All FNP examinations were evaluated by a single physician. The degree of choanal obstruction was recorded as percentage (%) with the help of the adenoid tissue image. The patients were divided into four groups according to the quality of the endoscopic examination performed during FNP examination; optimal assessment (group-1), assisted optimal assessment (group-2), assisted suboptimal assessment (group-3), and inability to assess despite assistance (group-4). LNX was performed for the re-evaluation of adenoid tissue in the patients in Group-3 and 4. Statistical analysis was performed among the groups according to the ages of the patients.
Results: Optimal images were obtained with FNP in the patients aged between 1 and 2 years and 8-15 years and the expected images were obtained for choanal obstruction. However, no image could be obtained with FNP for assessment of choanal obstruction in more than 30% of patients between the ages of 3 and 8 years (31.2% and 33.3%, respectively), also in more than 50% of the patients who were 4,5,6 and 7 years old (60.6%, 56.7%, 55.8%, 66 , 6%, respectively). For this reason, their degrees of choanal obstruction were determined with LNX.
Conclusion: For the optimal assessment of adenoid hypertrophy, we suggest that using LNX for the pediatric patients who are 4, 5, 6 and 7 years old and using FNP for the other age groups are more appropriate methods respectively in order not to disturb the polyclinic process of physician and for patient compliance.
Aim: Evaluation of nasopharyngeal punch biopsy results due to malignancy suspicion. Material and Method: In total, 491 patients (231 females 260 males; average age 36.72±16.91 years; range 16-90 years) were included in the present study. All patients' files were evaluated in terms of age, gender, the reason and the results of biopsy. Results: Nasopharyngeal carcinoma was diagnosed in 21 patients (4.2%) as a result of nasopharyngeal punch biopsies performed due to malignancy suspicion and exclusion. Results of pathological evaluation of other patients; 454 benign pathologies (lymphoid hyperplasia, chronic lymphoid process, Tornwald cyst) (92.05%), 12 insufficient materials (2.44%) and 4 granulomatous diseases (0.8%), respectively. The mean age of patients with malignancy was statistically significantly higher than those with benign pathology (p=0.000). There was no statistically significant difference in the gender distribution of malignant and benign cases (p=0.077). Conclusion: Taking punch biopsies containing mucosa and submucosa will provide the early diagnosis and treatment of nasopharyngeal carcinoma, in spite of the absence of a mass on endoscopic examination.
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