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Year: 2013  Vol. 17   Num. Suppl. 1  - Print:
ENDOSCOPIC SURGERY OF NASOPHARYNGEAL STENOSIS
Author(s):
Aliciane Mota Guimarães, Christiano de Giacomo Carneiro, Eduardo Boaventura Oliveira, Homero Carneiro Aferri, Manuela Athayde de Oliveira, Tallita dos Santos Souza
Abstract:

Goal: The nasopharynx can be the site of primary or secondary stenotic lesions. As in this case, they are more common after tonsillectomy, adenoidectomy, or uvuloplasty. Some organic disorders can result in naso-pharyngeal stenosis (NPS), including tertiary syphilis, lupus, diphtheria, tuberculosis, and bullous pemphigoid. NPS is a rare abnormality, and difficult to treat. We report a case of a patient with secondary NPS who underwent endoscopic surgery associated with the use of a palatal prosthesis. CASE REPORT: A 29-year-old man with a corrected bilateral cleft lip and palate and chronic nasal obstruction underwent a rhinoseptoplasty in 2000 and a septoplasty in 2003. He returned in 2008 with persistent nasal obstruction and epistaxis. We identified a granuloma in the pharyngeal region and performed a correction of the channel imperforation with a transpalatine approach and utilized nasopharyngeal cannulation postoperatively. In 2013, we identified an absence of the nasal septum, degenerated nasal mucosa, fibrosis, and obstruction of the palate and posterior nasopharynx during nasal endoscopy. We performed a palate stenosis correction using an endoscopic technique and separated the soft palate from the pharynx intraoperatively using a pharyngeal bulb. CONCLUSION: The incidence of NPS is low, which may impede the development of effective surgical techniques. Several treatment techniques are described in the literature, but NPS treatment remains a challenge, considering the high rate of symptom recurrence after surgical correction. Endoscopic management followed by the use of a prosthetic palate represents an important alternative to fix and maintain an opening at the site of NPS.

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