Fluoroscopy-Guided Transnasal Biopsy of Nasopharyngeal Carcinoma Using a Flexible Bronchoscopic Biopsy Forcep

Kim, Jai Keun; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik

Abstract

PURPOSE
Otolaryngoscopic biopsy of nasopharyngeal carcinoma is a generalized method which may be associatedwith inadequate sampling of tissue and patient discomfort. So, we tried fluoroscopy-guided transnasal biopsy using bronchoscopic biopsy forcep and evaluated its safety and efficacy.
MATERIALS AND METHODS
Prospectively weperformed fluoroscopy-guided transnasal biopsy in 11 patients who were radiographically suspected of nasopharyngeal carcinoma. The posterior wall of the nasopharynx was coated with barium sulfate under fluoroscopy. A flexible bronchoscopic biopsy forcep with a steerable guiding catheter which was used in removal of intrahepaticduct stones was inserted through the nare. After localization of the tip of the biopsy forcep at tumor site with fluoroscopy, a tissue specimen was obtained. We also tried CT guided biopsy in initial 2 cases. Each patient hadotolaryngoscopic biopsy to compare the biopsy result and patient discomfort.
RESULTS
We could have sufficientamount of tissue for pathological evaluation in 10 of 11 patients by the first pass with the fluoroscopic technique. Contrarily, otolaryngoscopic biopsy was successful in 7 of 11 patients on single passage. Additionally, 2 patients had complaint in our method comparing with 9 patients in otolaryngoscopic biopsy.
CONCLUSION
Fluoroscopy-guided transnasal biopsy of nasopharyngeal carcinoma using the bronchoscopic biopsy forcep is safe and accurate. It can be a appropriate method competing otolaryngoscopic biopsy.