Clinical Notes, New Instruments and Techniques: A New Nasopharyngeal Biopsy Forceps

Abstract

Biopsy of a lesion in the nasopharynx may be done through an oropharyngeal or an intranasal route. The oropharyngeal route usually requires a general anesthesia. If done under local anesthesia, it requires a thorough anesthesia with 2% tetracaine hydrochloride (Pontocaine) or 10% cocaine to eliminate the gag reflex and pain. This route, however, is not very satisfactory as it is difficult to visualize a lesion high up in the vault of the nasopharynx or the fossa of Rosenmuller, even thought the soft palate is well retracted. In my experience, the intranasal route is easier and more satisfactory. It is usually done under local anesthesia as an office procedure. The lesion is first spotted by posterior rhinoscopy. After packing both nostrils and nasopharynx with cotton pledgets soaked in a solution made up of equal parts of 2% tetracaine hydrochloride and 1% phenylephrine hydrochloride (Neo-synephrine) to obtain maximum shrinkage and anesthesia, the