Obliteration of right fossa of Rosenmuller. (TT - torus tubarius, X - tumour, SP - soft palate, arrow - eustachian tube opening)
Ipsilateral middle ear effusion.
Tumour (X) presenting as a mass involving roof-posterior wall junction of nasopharynx and spreading laterally causing obliteration of right fossa of Rosenmuller. (V - vomer, TT - torus tubarius, arrow - eustachian tube opening).
Solitary mass arising from left fossa of Rosenmüller
as seen through left nasal cavity.
Arrow -tumour, S- nasal septum, IT- inferior tubinate
NPC presenting as a well-defined 'polyp' (X). V - vomer, IT - tail of left inferior turbinate.
Ulcero-fungating tumour involving right fossa of Rosenmüller (left)
and fungating type involving the roof of nasopharynx (right)..
R-roof of nasopharynx
IT- inferior turbinate
S- nasal septum
Red arrow- ulcer
Yellow arrows- tumour
Curve green arrow- eustachian tube opening
Endoscopic view of nasopharynx as seen through right nasal cavity showing tumour (T) along left left Fossa of Rosenmüller. The corresponding CT-scan in axial cut is shown to show the tumour extension.
[TT - torus tubarius, R - roof of nasopharynx, V - vomerine end of nasal septum arrow - nasopharyngeal opening of eustachian tube]
Watch video of nasopharyngeal carcinoma endoscopy @ YouTube
Ipsilateral midde ear effusion of the same patient depicted in the video above which had caused conductive hearing loss, blocked ear sensation, and autophony.
Nasopharyngeal carcinoma lesion (dotted hexagon) before (above) and after NBI (below). (FOR - fossa of Rosenmüller, R - roof of nasopharynx)
Unilateral otitis media with effusion. Meastatic cervical
Massive bilateral metastatic lymphadenopathy, the so-called bull's neck appearance.
Spread of carcinoma into left orbit causing proptosis, cheimosis, ophthalmoplegia and blindness.
These figures show the appearance of the nasopharynx months after
completion of radiotherapy treatment of nasopharyngeal carcinoma.
Mucosal atrophy resulted in dry and thinner mucosal appearance.
The eustachian tube openings appeared blunted/obliterated.
The fossa of Rossenmuller (white dots) were clear of tumour recurrence.
Another example of post-irradiation changes of the nasopharynx in a "cured" patient 10 years after successful treatment of TI lesion involving
right fossa of Rosenmuller.
Trabecular pattern of mucosal scars post-irradiation.
Watch video of nasopharyngeal appearance after radiotherapy @ YouTube
Palatal palsy manifested as asymmetry of the throat and absent of movement on the affected side upon saying the the word "aaaa". The patient had NPC diagnosed 15 years ago and completed radiation and chemotherpy. He presented with hoarse voice, difficulty in swallowing and limited tongue movements 5 years later. His nutrition is via percutaneous gastrostomy which needs to be changed every 4 months. Endoscopic laryngoscopy showed bilateral fixed vocal cords with phonatory gap. The nasopharynx appeared clear of tumour with mucosal changes related to the definitive treatment given earlier. Electronic larynx was recommended to improved his voice as medialization procedure would caused glottic obstruction and resultant stridor.
These figures show the nasal endoscopy view of the posterior choana in post-irradiated nasopharynx of the same patient. The right posterior choana
has becomes narrower as compared to the contralateral side.
However, the patient didn't complaint any obstructive symptom.