Acquired Nasopharyngeal Stenosis

Abstract

Nasopharyngeal stenosis following adenoidectomy and/or tonsillectomy is difficult to correct. Multiple surgeries may be required to relieve the obstruction. Standard operative techniques using the lateral pharyngeal flap and transpalatal or endoscopic intranasal approaches were adapted to the clinical situation. Prolonged use of nasal stents is mandatory to produce a nasopharyngeal opening. Adjunctive treatment may include pressure equalization tubes. However, the best treatment remains prevention.

Complete Nasopharyngeal Stenosis: Presentation of a Rare Case

“…Nasopharyngeal stenosis patients can have several disorders that affect the upper aerodigestive system, including nasal obstruction, sleep apnea, swallowing difficulty, voice dysresonance, and eustachian tube and middle ear problems [5]. Our patient had almost all of these complaints.…”

“…However, in the past, it was mostly due to complications of infectious diseases, such as rhinoscleroma, diphtheria, syphilis and tuberculosis [1,3]. In childhood, NPS can also be observed after adenotonsillectomy, but the incidence of this complication in both adults and children is very rare [4][5][6].…”

“…If nasopharyngeal stenosis originates in the soft palate, the use of a laterally based pharyngeal flap is another currently used method of reconstruction. The success of a laterally based pharyngeal flap depends on the use of healthy pharyngeal tissue in the area of the stenosis [5]. Prosthetic nasopharyngeal stents have also been successfully used in some patients [2].…”

Endoscopy in Nasopharyngeal Adenoid Surgery

“…Excessive bleeding in the operative field may limit the view, but this should not be an indication to abort the surgery except in very rare cases, and if such case occurs it can be managed by regular packing for a few minutes, and then continuing surgery. (Giannoni et al, 1998).  Eustachian tube injury, if the torus tubarius is cauterized or denuded  Meningitis, after injecting lidocaine and epinephrine into the posterior nasopharynx prior to adenoidectomy.…”

Stenting the nasopharyngeal isthmus by nasopharyngeal airway after correction of acquired total nasopharyngeal obstruction: surgical procedure and results

“…Even with optimal planning and surgical technique, many patients require repeat operations to obtain satisfactory results. Stepnick [8] reported recurrent scarring and stenosis within 6 weeks of treating nasopharyngeal stenosis with the placement of a free flap and a local laterally based flap is not always successful and depends on the presence of healthy pharyngeal tissue to rotate onto the stenosed surface [9].…”