THE VALUES OF PERNASAL BIOPSIES AND MANAGEMENT OF NASOPHARYNGEAL TUMOURS IN RESOURCE POOR ENVIRONMENT

PERNASAL BIOPSIES AND MANAGEMENT OF NASOPHARYNGEAL TUMOURS

Abstract

ABSTRACT

Background: There are increasing cases of nasopharyngeal tumours globally. This requires prompt and accurate treatment for survival. The current global task imposed by the COVID-19 pandemic further raises the need to approach investigation of diseases with cheap but standard technique. This article aimed to present the histological yield of per nasal biopsies in patients with suspected sinonasal/nasopharyngeal tumours.

Methodology: This is a six years retrospective review of patients’ record from June 2016 to May 2021. Inclusion criteria were patients in whom general anaesthesia constituted high risk and who accepted local anaesthesia and those who could not afford the cost of biopsy under general anaesthesia but underwent transnasal nasopharyngeal biopsies with local anaesthesia on the ward.

Results: The gender ratio was 1.4:1. with median age of 45 years. The area involved in decreasing order are the nose, ear, neck and neuro-ophthalmic in 10(83.3%), 7(58.3%), 6(50%) and 3(25.0%) respectively. The left nasal cavities were involved in 10(83.3%) and right in 2(16.7%). Flexible Rhinopharyngoscopy was done in only 4(33.3%). CT scan was carried out in 6(50.0%) with findings ranging from isodense masses in the nasal cavity extending to the maxillary, frontal and the right and left globes in 2(16.7%).  The tumours were malignant in 11(91.7%) and benign (pleomorphic adenoma) in 1(8.3%). The malignant cases comprise of 10(90.9%) Nasopharyngeal carcinomas (NPCs) and 1(9.1%) sinonasal adenoid cystic carcinoma (cribriform type). Overall, early (within 6 months) and late presentations (seven months to thirty-six months) were in 33.3% and 66.7% respectively. Affordability of chemoradiation treatment were in 2(18.2%) and none in 9(81.2%).

Conclusion: Despite the advantage of reducing the cost of investigations and risk of anaesthesia, most vital radiological investigations such as CT-Scan and MRI were not carried out.

 

Keywords: Nasopharyngeal carcinomas, pernasal biopsy, pleomorphic adenoma