DEFINITION of PHARYNXDEFINITION of PHARYNX
• The pharynx is that part of the digestive tube which is placed behind the nasal cavities, mouth, and larynx. It is a wide musculomembranous tube, somewhat conical in form, with the base upward, and the apex downward, extending from the under surface of the skull to the level of the cricoid cartilage in front, and that of the sixth cervical vertebra behind .
NASOPHARYNXNASOPHARYNX
It lies behind the nose and above the level of the soft palate.It differs from the oral and laryngeal parts of the pharynx in that
its cavity always remains patent. In front it communicates through the choanæ with the nasal
cavities. On its lateral wall is the pharyngeal ostium of the auditory
tube, somewhat triangular in shape, and bounded behind by a firm prominence, the torus or cushion,.Behind the ostium of the auditory tube is a deep recess, the pharyngeal recess (fossa of Rosenmüller).
On the posterior wall is a prominence, best marked in childhood, produced by a mass of lymphoid tissue, the adenoids.
The adenoidsThe adenoids
• are a clump of lymphoid tissue similar to that of tonsils, but located higher up in the throat, behind the nose. Adenoids help the body fight infections by trapping and fighting micro organisms as they pass through the breathing passage.
Indications for adenoidectomyIndications for adenoidectomy
• Adenoidectomy is indicated if there is a chronic effusion in the middle ear in an adult, especially on one side only, which does not resolve relatively rapidly (3-6 weeks) with proper medical treatment.
• Obstruction behind the nose causing snoring, airway obstruction, or poor sleep
Adenoidectomy Indicated whenAdenoidectomy Indicated when
Enlarged adenoids are blocking the airway, which may be suspected if the child
snores excessively has trouble breathing through the nose has episodes of not breathing during sleep The child has chronic ear infections that: interfere with child's education persist despite antibiotic treatment recur 5 or more times in a year recur 3 or more times a year during a 2-year period
AdenoidectomyAdenoidectomy
• The adenoids normally shrink as the child reaches adolescence and adenoidectomy is rarely needed after reaching the teenage years. Adenoidectomy can done as an outpatient procedure in good set ups.. Complete recovery takes 1 to 2 weeks. While healing, the child may have a stuffy nose, nasal drainage, and a sore throat. Soft, cool foods and drinks may help relieve throat discomfort.
definition
angiofibromas are highly vascular, non-encapsulated tumours affecting predominantly young males.
These lesions are benign histologically but they may become life-threatening with excessive bleeding or intracranial extension.
JUVENILE NASOPHARYNGEAL ANGIOFIBROMAJUVENILE NASOPHARYNGEAL ANGIOFIBROMA
STUDY PERIOD – 1984 TO 2004STUDY PERIOD – 1984 TO 2004
60 CASES60 CASES
ALL CASES EVALUATED ACCORDING TO A QUESTIONNAIRE
FOLLOWUP – 18 MONTHS TO 4 YEARS
PRE-OP TRACHEOSTOMY IN ALL PATIENTS
JUVENILE NASOPHARYNGEAL JUVENILE NASOPHARYNGEAL ANGIOFIBROMAANGIOFIBROMA
60 CASES60 CASES
ALL MALES
AVERAGE AGE – 17 YEARS
(RANGE 12-22 YRS)
JUVENILE NASOPHARYNGEAL ANGIOFIBROMAJUVENILE NASOPHARYNGEAL ANGIOFIBROMA
COMMON PRESENTATIONCOMMON PRESENTATION
N = 60N = 60
EPISTAXIS
NASAL BLOCKAGE
EAR COMPLAINTS
FACIAL SWELLING
JUVENILE NASOPHARYNGEAL ANGIOFIBROMAJUVENILE NASOPHARYNGEAL ANGIOFIBROMA
COMPLICATIONSCOMPLICATIONS
PRIMARY HAEMORRHAGE – 1 L (Ave)
SECONDARY HAEMORRHAGE – 3 PATIENTS
WOUND INFECTION – 3 PATIENTS
CONDUCTIVE HEARING LOSS – 1 PATIENT
HYPERTROPHIED SCAR – 3 PATIENT
JUVENILE NASOPHARYNGEAL ANGIOFIBROMAJUVENILE NASOPHARYNGEAL ANGIOFIBROMA
FOLLOWUPFOLLOWUP18 MONTHS TO 4 YEARS18 MONTHS TO 4 YEARS
RECURRENCE
11 PATIENTS (18.3 %)
JUVENILE NASOPHARYNGEAL ANGIOFIBROMAJUVENILE NASOPHARYNGEAL ANGIOFIBROMA
CONCLUSIONSCONCLUSIONS
SURGERY IS THE TREATMENT OF CHOICESURGERY IS THE TREATMENT OF CHOICE
MOST COMMON PRESENTATION IS EPISTAXISMOST COMMON PRESENTATION IS EPISTAXIS
BEST APPROACH IS TRANSPALATAL WITH LAT. BEST APPROACH IS TRANSPALATAL WITH LAT. RHINOTOMYRHINOTOMY
FOLLOW UP CT SCAN AFTER 6 MONTHSFOLLOW UP CT SCAN AFTER 6 MONTHS