A rare complication of nasopharynx biopsy – abscess in nasopharynx

Introduction Nasopharynx biopsy is a standard procedure to diagnose pathologies in the nasopharynx and used for unclear eustachian tube dysfunction.

Case A 66-year-old male patient with an unclear chronic tube ventilation disorder on the right ear underwent a bougie dilation of the right eustachian tube, tympanic drainage and a nasopharynx biopsy. A malignant tumor could be excluded according to the histopathology. Two months later, he presented with a swelling in the nasopharynx, headache and neck pain. Fever was not measurable. An oral therapy with cefuroxime for eight days did not lead to any improvement. The clinical examination showed the tympanic drainage on the right in situ with mucous secretion and purulent secretion in nasopharynx. An audiogram showed an unchanged sensorineural hearing loss on both sides. Additionally, computed tomography (CT) and magnetic resonance imaging (MRI) of the skull and cervical spine were performed. An abscess at the level of the nasopharynx retro- and lateropharyngeally in the carotid space next to the skull base could be found, with a size of 37 x 15 x 20 mm. During endoscopy, granulation tissue was found on the right side of the nasopharynx. After removal of the granulation tissue, the abscess cavity was found. The microbiological examination showed negative results, antibiotic therapy with levofloxacin was initiated for 3 months because of the inflammatory erosion of the skull base described in the CT. There was a clear improvement in the clinical findings.

Conclusion Nasopharyngeal abscesses can occur after a standard procedure such as a nasopharynx biopsy. The extent of the influence of the bougie dilation on the eustachian tube on this remains open. A surgical incision and a drainage are the treatment of choice.

Poster-PDF A-1354.pdf

Conflict of interest

Der Erstautor gibt keinen Interessenskonflikt an.

Publikationsverlauf

Artikel online veröffentlicht:
13. Mai 2021