Radiography of the nasopharynx in children: implementation, results
Nasopharynx – the upper part of the pharynx, communicating with the nasal cavity and the middle ear. Examination of this anatomical education, because of the arrangement, is impossible without use of special tools. So, posterior rhinoscopy is the main method that uses the ENT doctor to assess the condition of the nasopharynx, is performed by using a nasopharyngeal mirror introduced through the mouth. It allows you to identify inflammation of the mucous membrane, to detect space-occupying lesions, but is not applicable in some situations: if you cannot open your mouth or have young children. In the latter case, you can resort to pallavolo study. But for visual assessment of pathology appointed by the instrumental methods, one of which is an x-ray of the nasopharynx.
This study, despite the radiation dose to the patient, in some cases, is most preferred. Endoscopy is not associated with the risk of radiation exposure, but is an invasive procedure, is often inapplicable in the examination of young children. Computed tomography (CT) is more informative, but requires from the patient a long time to be in a fixed position, which is problematic for the child.
The implementation of x-ray child sometimes requires fixing the last one. For retention restless patient can bring accompanying his parents, but in this case you need to provide protection from radiation: a special apron or gloves. The woman participating in the fixing of the child should be completely sure in the absence of her pregnancy.
Attention! The radiation dose when the picture was taken is 0.02 or 0.04 mSv for digital or film radiographs, respectively, which does not exceed 2-4% of the annual rate of 1 mSv.
Decoding of the result
X-ray examination of the nasopharynx is usually assigned to identify foreign bodies, determine the extent of overgrowth of the adenoids in children (if you can’t perform endoscopic examination) and assessment of tumor progression. However, in the latter case, much more information can be obtained by performing a CT scan.
How does the pathology in the picture (examples of some common diseases of the nasopharynx):
- Angiofibroma (juvenile fibroma). Clinically manifested by obstruction of nasal breathing until the inability to breathe through the nose, snuffling voice, nasal discharge – mucopurulent or bloody, epistaxis. At an advanced stage with a significant tumor size occurs facial deformation, displacement of the eyeball, there are pain and neurological symptoms due to compression of the nerves. On the x-ray is manifested by deformation of the bone structures. A characteristic feature – the anterior displacement of the posterior wall of the maxillary sinus.
- Adenoids – hypertrophy of lymphoid tissue of the nasopharynx, the common pathology of children’s age. The child is not breathing nose, especially during sleep, snoring, it changes the timbre of the voice can cause hearing loss. On the x-ray in lateral projection the adenoids are visible as a shadow emanating from the posterior wall of the nasopharynx. The degree of closure of the lumen of the latter can judge the stage of the disease. Shadow, occupying ⅓ of the nasopharynx, evidence I degree of proliferation of the adenoids, ½ — II degree, more than ⅔ and – III degree.
- Cancer of the nasopharynx. Symptoms: nasal congestion, bloody discharge with an unpleasant smell, nosebleeds, hearing and swallowing, ringing in the ears, headache. When evaluating x-ray pay attention to the degree of proliferation of tumor – signs of destruction and deformation of bones.
- Foreign bodies is a common problem in young children. On radiographs they appear as intensely colored shadows. Especially well rendered metal objects.
Attention! X-ray is not one of the most informative methods of investigation of the nasopharynx. Infringiendo, rigid endoscopy, and CT allow you to learn about the diagnosed pathology is much more important for the purposes of treatment and determining the indications for surgery, for example, a child with adenoids.
How else can you examine the nasopharynx?
With the development of medicine x-ray of the nasopharynx is no longer the leading method for detection of diseases of this anatomical region. Its advantages in the examination of the child reduced to the short duration of the study (compared to CT) and the lack of need for insertion through the nose or mouth diagnostic equipment like endoscopy. However, the informativeness of x-rays is inferior to the specified methods.
Examination of the nasopharynx is possible in several ways: through the mirror (posterior rhinoscopy) or endoscope. These methods allow to assess the condition of its mucous membrane, to detect pathological education (adenoids, papillomas, polyps). To clarify the diagnosis when revealing the last resort to biopsy. However, the introduction of diagnostic tools is not always possible. For example, young children are very negatively related to invasive procedures.
CT scan – another method of beam diagnostics, is to obtain cross-sectional images of the study area. Gives a much clearer image is indispensable for the assessment of the prevalence of guidance. The method, however, is associated with the irradiation of the patient, and the research time is up to 15 minutes, which is unacceptable for a small child. Has the value and price. X-ray in the presence of policy OMS can be done for free, but CT, with rare exceptions, is performed by the patient.
Thus, x-ray, though is obsolete and uninformative way of detecting diseases of the nasopharynx, has not lost its value in the examination of patients, because of age or mental condition are unable to perceive other diagnostic manipulation. He also becomes the only possible method if the patient can not pay for other studies or to their benefit.