OtoRhinoLaryngology Portal

The Leading Online Gallery of Otolaryngology and Head & Neck Surgery Specialty

OtoRhinoLaryngology Portal Video Collections @

YouTube & MEDtube

Inverted Papilloma


Unilateral nasal polyps in a middle-age patient.  Endoscopic morphology appearance is indistinguishable from ethmoidal polyps. Postnasal space examination revealed a more solid mass crossing over to the contralateral side.  Imaging study is necessary and deep biopsy would show its characteristic histopathologic features. 


Deep biopsy of suspected inverted papilloma.

Hyperplastic antral mucosa after left endoscopic maxillectomy performed.

[N- nasopharynx, MT- middle turbinate]


Watch video of inverted papilloma @ YouTube


Stage I juvenile nasopharyngeal angiofibroma.


Staging systems evolution


Chandler e al, (1984); Sessions et al, (1981); Radkowski et al, (1996)

Haemangioma of Inferior Turbinate




Bleeding benign vascular tumour arising from lateral surface of left inferior turbinate.  It was successfully excised via endoscopic  approach with preservation of uninvolved tissues.


[S - nasal septum,C - blood clot at posterior nasal cavity, IT - inferior turbinate, T - tumour, BD - bipolar suction diathermy probes]


Watch video of Nose Bleeds From Benign Vascular Tumour of Inferior Turbinate @ YouTube 

Bleeding From Hypervascular Haemangioma


Histopathologically confirmed haemangioma (X).

Histopathologically confirmed haemangioma (X).

Profuse bleeding from tumour upon manipulation.


Meningioma (histologically-proven) presenting as unilateral nasal blockage and headache.  Endoscopy showed right-sided tumour mass (T) which appeared vascular.  CT-scan revealed tumour extension to anterior skull base

and into right frontal lobe. 

[MT - middle turbinate, IT - inferior turbinate, S - nasal septum]

Nasopharyngeal Carcinoma Lecture Series by Lori J Wirth

Nasopharyngeal Carcinoma: Obliteration of Fossa of Rosenmüller in Early Tumour

Nasopharyngeal Carcinoma: Post-nasal Endoscopic Appearance of Tumour at Various Stages



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

Watch video of postnasal space tumour biopsy @ YouTube


Narrow Band Imaging (NBI) Technology

 Nasopharyngeal carcinoma lesion (dotted hexagon) before (above) and after NBI (below).  (FOR - fossa of Rosenmüller, R - roof of nasopharynx)

Nasopharyngeal Carcinoma: Extranasal Manifestations

             Unilateral otitis media with effusion.        Meastatic cervical

                                                                    lymphadenopathy (arrow)

Massive bilateral metastatic lymphadenopathy, the so-called bull's neck appearance.

Nasopharyngeal Carcinoma: Right Lateral Rectus Palsy

Nasopharyngeal Carninoma: Orbital Spread

Spread of carcinoma into left orbit causing proptosis, cheimosis, ophthalmoplegia and blindness.

Nasopharyngeal Carcinoma: Mucosal Appearance after Radiotherapy [Complete Response in Remission]


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

Posterior Choanal Stenosis: Acquired

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.