Nasopharyngeal biopsy

Nasopharyngeal biopsy is a commonly used method for confirming nasopharyngeal lesions, especially nasopharyngeal malignancies. Because China is one of the high incidence areas of nasopharyngeal carcinoma, it is necessary to be familiar with the anatomy of the nasopharynx and nasopharyngoscopy. Master the method of nasopharyngeal biopsy. There are two methods currently used: nasopharyngeal biopsy through the oral route and nasopharyngeal biopsy through the nasal route. The best treatment time: general surgery is recommended to be treated after the initial diagnosis of the disease, special surgery should be prescribed. Treatment of diseases: nasopharyngeal angiofibroma, nasopharyngoma Indication Clinically diagnosed nasopharyngeal lesions, especially those suspected of nasopharyngeal carcinoma, should be biopsied. However, it is generally not suitable for biopsy of nasopharynx fibrous aneurysm and skull base tumor to avoid serious complications. In addition, melanoma is easy to diagnose because of clinical diagnosis, and biopsy is easy to spread, so no biopsy is performed. Contraindications 1, there is skull base bone destruction or paranasal infiltration, cranial nerve damage or distant metastasis. 2, there are liver and kidney dysfunction, poor overall condition. Preoperative preparation Explain to the patient the purpose of spraying the anesthetic liquid and the temporary nature of the pharyngeal discomfort after spraying, so that the patient can relieve the concern and actively cooperate. Surgical procedure 1. Nasal biopsy through the oral route. The assistant or the patient's own tongue depressor presses the tongue down. The operator holds the indirect nasopharyngoscope on the left and the nasopharyngeal biopsy force in the right hand. After clarifying the lesion, the tissue is bitten at this point. If the nasopharyngeal cavity is small and the exposure is poor, the soft palate can be pulled open with a soft sputum hook, or the catheter can be pulled into the pharynx from the nasal cavity, and the two ends of the catheter are pulled out from the front nostril and the mouth respectively, and the knot is tightened instead of the soft shackle. To widen the nasopharyngeal cavity and facilitate exposure. 2, nasal route through the nasopharyngeal biopsy in addition to the pharyngeal spray to make the nasopharyngeal cavity anesthesia, the nasal cavity also needs to be surface anesthesia, and then the nasopharyngeal biopsy forceps or nasal biopsy forceps directly from the front side of the affected side of the nose to the nasopharynx Align the direction of the tumor and take a biopsy. The application of direct nasopharyngoscopy is also through the nasal passage to reach the nasopharyngeal cavity. In case of turbinate hypertrophy or septum deviation obstructing the biopsy forceps or the lens tube, the nose and mucosa may be converged with 1% ephedrine solution as appropriate. complication Incision delayed healing and wound infection.