[It would be easier without physicians!].
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Biomedical subjects
Publications and source records attributed to L Bohman.
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The physical characteristics of the fascial planes of the nasopharynx provide a basis for categorizing growth patterns of the more common benign nasopharyngeal masses. Lymphoid hyperplasias are confined to the surface by the very dense pharyngobasilar fascia that lies beneath the submucosa. It takes a very aggressive process to cross this fascial plane. More laterally throughout the paranasopharyngeal space the loose areolar nature of the buccopharyngeal fascia permits benign tumors in this space to assume a spherical configuration. The carotid sheath is also a loose areolar arrangement that permits free movement of the carotid artery in the neck. Juvenile angiofibromas permeate natural foramina, displace bony septa, and extend widely but do not invade the carotid sheath. Neurogenic tumors and paragangliomas are intimately associated with contents of the carotid sheath; therefore, they obliterate the low density regions surrounding the carotid vessels.
In 52 normal nasopharyngeal computed tomographic (CT) scans the various tissue planes deep to the mucosa were always seen and appeared symmetric. The superficial structures were more often asymmetric; however, by using physiologic maneuvers, coronal scanning, and this very reliable deep plane anatomy, a highly accurate interpretation is possible. A knowledge of these simple scanning techniques and of the range of normal anatomy will help radiologists avoid the equivocal and false-positive interpretations that plague other radiographic studies of this area. Because of its deep plane information, CT best complements the clinical evaluation of the nasopharynx, and should be the radiographic examination of choice.