Radiological profiles of nasopharyngeal anatomy as seen in computed tomography scans of normal patients undergoing brain scans for other neurological problems in Konkani population


  • Santhosh Kumar Rajamani Department of ENT, B.K.L Walawalkar Rural Medical College, Chiplun, Ratnagiri, Maharashtra, India
  • Nayanna Karodpati Department of ENT, B.K.L Walawalkar Rural Medical College, Chiplun, Ratnagiri, Maharashtra, India
  • Dilesh A. Mogre Department of ENT, B.K.L Walawalkar Rural Medical College, Chiplun, Ratnagiri, Maharashtra, India
  • Rashmi Prashant Department of ENT, D Y Patil Medical College, Pune, Maharashtra, India



Multidetector computed tomography, Nasopharynx, Anatomy, Nasopharyngeal carcinoma


Background: Nasopharyngeal carcinoma arises from interactions between underlying genetic and racial predilection and variety environmental factors. It is locally aggressive and presents with occult cervical nodal metastasis. A thorough understanding of radiological regional anatomy of the nasopharynx in Indians particularly Konkani population is important for early detection of nasopharyngeal carcinoma.

Methods: Routine computed tomography of brain, head and neck for other neurological problems like stroke clearly delineates the loco-regional anatomy of the nasopharynx. Computed tomography (CT) images stored in the computer system were studied to delineate the normal loco-regional anatomy of nasopharynx with special reference to anatomical structure of fossa of Rosenmueller and to find out the normal dimensions of nasopharynx in Konkani population. Nasopharyngeal carcinoma is a hidden and cryptic killer with relatively higher incidence among young population. To develop a local screening CT program for earlier detection of this occult malignancy was another purpose of this endeavour.  

Results: Internal carotid artery lies at the depth of around 1 to 1.7 cm from floor of lateral pharyngeal recess (fossa of rosenmuller); this figure has to be borne in mind while doing invasive procedures of nasopharynx like biopsies and adenoidectomy.

Conclusions: Posterior pharyngeal wall thickness of more than 2.4 cm and adenoid mass extending to posterior margin of the medial pterygoid plate is suspicious of malignancy. A screening protocol of CT nasopharynx has been suggested as a fruit of this endeavour.


Renko M, Kristo A, Tapiainen T, Koivunen P. Nasopharyngeal dimensions in magnetic resonance imaging and the risk of acute otitis media. J Otol Laryngol. 2017;121(9):853-6.

Ward FW, McNicholas WT. Clinical prediction of the sleep apnea syndrome. Sleep Med. 1997;1(1):19-32

Todd TW. Integral growth of pace: I. The nasal area. Am J Orthdontia Oral Surg. 1936;22(4):321-34.

Hairfield WM, Warren DW. Dimensions of the cleft nasal airway in adults: a comparison with subjects without cleft. J Cleft Palate. 1989;1:9-13.

Bresolin D, Shapiro PA, Shapiro GG, Chapko MK, Dassel S. Mouth breathing in allergic children: its relationship to dentofacial development. Am J Orthod. 1983;83(4):334-40.

Fujioka M, Young LW, Girdany BR. Radiographic evaluation of adenoidal size in children: adenoidal-nasopharyngeal ratio. Am J Roentgenol. 1979;133:401-4.

Teresi LM, Lufkin RB, Vinuela F. MR imaging of the nasopharynx and floor of the middle cranial fossa—part I: Normal anatomy. Radiology. 1987;164:811-6.

El-Anwar MW, Ali AH, Elnashar I, Elfiki IM, Ahmed AF, Abdulmonaem G. Normal Nasopharyngeal Measurement by Computed Tomography in Adult. J Craniofac Surg. 2017;28(4):395-8.

Oon CL. Some sagittal measurements of neck in normal adults. Br J Radiool. 1964;1(37):674-7.

Øyvind H, Harper David AT, Ryan Paul D. PAST: Paleontological statistics software package for education and data analysis. Palaeontologia Electronica. 2001;4(1):9-10.

Mancuso AA, Bohman L, Hanafee W, Maxwell D. Computed Tomography of the Nasopharynx: Normal and Variants of Normal. Radiology. 1980;137:113-21.

Feinstein AR. Clinical epidemiology the architecture of clinical research. Philadelphia; Saunders publishers: 1985;10:111-45.

Teresi LM, Lufkin RB, Vinuela F. MR imaging of the nasopharynx and floor of the middle cranial fossa-part I: Normal anatomy. Radiology. 1987;164:811-6.

Chong VFH, Fan YF. Radiology of the nasopharynx: Pictorial essay. Aust Radiol. 2000;44:5-13.

Mancusco AA, Harnsberger HR, Muraki AS, Stevens MH. Computed tomography of cervical and retropharyngeal lymph nodes: Normal anatomy, variants of normal, and applications in staging head and neck cancer. Part I. Normal anatomy. Radiology. 1983;148:709-14.

Mukherji SK, Weissman JL, Holliday R. The pharynx. In Head and Neck Imaging;H, C, Ed.; Mosby: New York, 1996;6:437-488.

Bloch S, Danziger J. Radiological experience with nasopharyngeal masses. J South African Med. 1973;47:2380-3.

Dickson RI, Flores AD. Nasopharyngeal carcinoma:an evaluation of 134 patients treated between 1971-1980. Laryngoscope. 1985;95:276-88.

Zeng Y. Seroepidemiological studies on nasopharyngealcarcinoma in China. Arch Cancer Res. 1985;44:121-38.

Woo J, Sham CL. Diagnosis of nasopharyngeal carcinoma. Ear Nose and Throat Journal. 1990;69:241-2.

Lam WW, King AD, Ahuja AT, Metreweli C. Imaging. In: vanHasselt CA, Gibb AG(eds). Nasopharyngeal carcinoma, 2nd edn. Hong Kong: Chinese University Press; 1999: 127-160.

Waldron J, Kreel L, Metreweli C, Woo JKS, Van Hasselt CA. Comparison of plain radiographs and computed tomographic scanning in nasopharyngeal carcinoma. Clin Radiol. 1992;45:404-6.






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