Radıologıcal Evaluatıon of the Recesses on the Posterıor Wall of the Nasopharynx wıth Cone-beam Computed Tomography

Abstract

Background: The posterior wall of the nasopharynx is composed of loose connective tissue that includes many important anatomical structures. Various structures, such as the opening of the Eustachian tube (ET), the Rosenmüller fossa (RF), and the pharyngeal bursa (PB) are found here. Aim: To evaluate the nasopharynx posterior wall anatomic structures, including the Eustachian tube, Rosenmüller fossa, and pharyngeal bursa with cone-beam computed tomography. Materials and Methods: The depth, width, and length of the Eustachian tube, Rosenmüller fossa, and pharyngeal bursa were measured in 150 patients using axial-sagittal cone-beam computed tomography. The Eustachian tube and Rosenmüller fossa distance to the midsagittal plane, the coronal region passing through the posterior end of the nasal septum, the superior-inferior extremity of the recesses, and the nasal floor plane distance were measured. The relationship between Rosenmüller fossa types and other parameters were evaluated. Results: The incidence of right Rosenmüller fossa types 1, 2, and 3 were 16%, 18%, and 66%, respectively, and that of the left Rosenmüller fossa types 1, 2, and 3 were 16%, 19.3%, and 64.7%, respectively. The mean pharyngeal bursa width, length, and depth were 10.8, 5.7, and 4.0 mm, respectively; those of the Eustachian tube were 5.6, 7.1, and 7.3 m, respectively; those of the right Rosenmüller fossa were 4.0, 12.4, and 10.5 mm, respectively; and those of the left Rosenmüller fossa were 3.8, 12.5, and 10.9 mm, respectively. Conclusions: The posterior wall of the nasopharynx contains several important anatomical structures. Evaluation of these using cone-beam computed tomography has many clinical and radiological advantages. To understand and interpret the coincidental findings in CBCT, dental radiologists should have access to more detailed information concerning the anatomy of the nasopharynx.

Obstructive Sleep Apnea and Role of the Diaphragm

“…The airflow passes from the nasopharynx (or rhino-pharynx) to the oropharynx and then to the hypopharynx; these latter anatomical areas may become obstructed in patients with peripheral OSA [34]. The posterior area of the nasopharynx consists of loose connective tissue, in which area we can find some important structures such as the Eustachian tube, the pharyngeal bursa, and the Rosenmüller fossa (or lateral pharyngeal recess) [35].…”

“…The nasopharynx is located between the pharyngeal vault (non-muscular non-collapsing upper end of the nasopharynx) and the upper face of the soft palate, putting the nasal cavities in continuity with the oropharynx [35]. The soft palate is made up of five muscles covered by mucus membranes: tensor veli palatini (TVP), levator veli palatini (LVP); musculus uvulae or uvular muscle (UM); palatoglossus (PG), and palatopharyngeus (PP) [42,43].…”

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

“…The posterior wall of the nasopharynx has important anatomical structures and consists of loose connective tissue (1). Some of these important anatomical structures are the pharyngeal recess (PR), the pharyngeal bursa (PB), and the Eustachian tube (ET).…”

“…During nasotracheal intubation, if the end of the nasotracheal tube strikes the posterior wall of the nasopharynx, this can lead to retropharyngeal dissection and other serious complications (2). Being aware of the differences in the anatomy of the nasopharyngeal region can reduce the risk of such complications during nasotracheal intubation (1). In addition, it has been reported that calcific formations (3) such as rhinoliths, and structures such as Tornwaldt cysts (4), which are epithelial remnants of embryological origin, can be seen in this region.…”

“…It also allows the acquisition of noninvasive, accurate measurements and three-dimensional images of anatomical structures and spaces (10). The use of CBCT has many advantages such as low radiation dose, high bone resolution, ease of use, and accessibility (1).…”