Hüseyin ERDEM, Mustafa TEKELİ, Yiğit ÇEVİK, Nazire KILIÇ ŞAFAK, Ömer KAYA, Neslihan BOYAN, Özkan OĞUZ

Quantitative Assessment of the Pharyngeal Recess Morphometry in Anatolian Population Using 3D Models Generated from Multidetector Computed Tomography Images

Aim: It was aimed to analyze the detailed morphometry of the pharyngeal recess (PR) using three-dimensional (3D) models reconstructed from multidetector computed tomography (MDCT) images. Material and Methods: This study was a retrospective analysis and performed on MDCT images of 97 patients (43 males, 54 females). 3D models of the PR were reconstructed using 3D Slicer software, enabling morphometric measurements according to established protocols. Measurements included PR depths, distances between the posterior nasal spine and torus levatorius (PNS-TL), distances between right and left TL (RTL-LTL) distances between the PNS and posterior wall of the nasopharynx (PNS-PWN), the angle (α) between the centerline of the PR and the sagittal plane. The morphologies of the PR classified into three types. Results: The average measurements for the parameters were as follows: PR depth - 10.42 mm, distance between PNS and TL - 10.40 mm, distance between RTL and LTL - 19.13 mm, distance between PNS and PWN - 19.92 mm, and the angle (α) - 53.65°. The prevalence of PR types was 20.62%, 47.42% and 31.96% for type 1, type 2 and type 3, respectively. Conclusion: Variations in reported measurements of the pharyngeal recess can be attributed to imaging techniques, patient positioning, anatomical differences, and sample sizes. The use of 3D models generated from MDCT datasets offers a high-resolution and comprehensive approach to understanding the PR's morphometry and spatial relationships, enabling accurate measurements and advancing our knowledge of this anatomical region.

Keywords:

3D slicer, multidetector computed tomography, nasopharyngeal carcinoma, nasopharynx, pharyngeal recess,

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1. Mudry A. Pharyngeal recess or Rosenmuller's fossa: Its first description revisited. Head Neck. 2021;43:2295-6.
2. Amene C, Cosetti M, Ambekar S, et al. Johann Christian Rosenmuller (1771-1820): A historical perspective on the man behind the fossa. J Neurol Surg B Skull Base. 2013;74:187-93.
3. Chen YP, Chan ATC, Le QT, et al. Nasopharyngeal carcinoma. Lancet. 2019;394:64-80.
4. Erdem S, Zengin AZ, Erdem S. Evaluation of the pharyngeal recess with cone-beam computed tomography. Surg Radiol Anat. 2020;42:1307-13.
5. Mankowski NL, Bordoni B. Anatomy, head and neck, nasopharynx. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557635/ access date 25.05.2023.
6. Tang Y, Bie X, Yu S, Sun X. Study of the anatomical structure of the nasopharyngeal cavity and distribution of the air flow field. J Craniofac Surg. 2020;31:1937-41.
7. King AD, Zee B, Yuen EH, et al. Nasopharyngeal cancers: Which method should be used to measure these irregularly shaped tumors on cross-sectional imaging? Int J Radiat Oncol Biol Phys. 2007;69:148-54.
8. Chen J, Luo J, He X, Zhu C. Evaluation of contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) in the detection of retropharyngeal lymph node metastases in nasopharyngeal carcinoma patients. Cancer Manag Res. 2020;12:1733-9.
9. Sutthiprapaporn P, Tanimoto K, Ohtsuka M, et al. Improved inspection of the lateral pharyngeal recess using conebeam computed tomography in the upright position. Oral Radiol. 2008;24:71-5.
10. Erdem H, Cevik Y, Safak NK, et al. Morphometric analysis of the infratemporal fossa using three-dimensional (3D) digital models. Surg Radiol Anat. 2023;45:729-34.
11. Guo R, Mao YP, Tang LL, et al. The evolution of nasopharyngeal carcinoma staging. Br J Radiol. 2019;92:20190244.
12. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15:155-63.
13. Tang LL, Chen YP, Chen CB, et al. The chinese society of clinical oncology (CSCO) clinical guidelines for the diagnosis and treatment of nasopharyngeal carcinoma. Cancer Commun (Lond). 2021;41:1195-227.
14. Jacobs R, Salmon B, Codari M, et al. Cone beam computed tomography in implant dentistry: recommendations for clinical use. BMC Oral Health. 2018;18:88.
15. MacDonald D. Cone-beam computed tomography and the dentist. J Investig Clin Dent. 2017;8:10.
16. Sutthiprapaporn P, Tanimoto K, Ohtsuka M, et al. Positional changes of oropharyngeal structures due to gravity in the upright and supine positions. Dentomaxillofac Radiol. 2008;37:130-5.
17. Kaplan FA, Bayrakdar IS, Bilgir E. Evaluation of rosenmuller fossa with cone beam computed tomography: A retrospective radio-anatomical study. Selcuk Dent J. 2019;6:195-9.
18. Kaplan FA, Saglam H, Bilgir E, et al. Radiological evaluation of the recesses on the posterior wall of the nasopharynx with cone-beam computed tomography. Niger J Clin Pract. 2022;25:55-61.
19. Loh LE, Chee TS, John AB. The anatomy of the fossa of rosenmuller: Its possible influence on the detection of occult nasopharyngeal carcinoma. Singapore Med J. 1991;32:154- 5.
20. Serindere G, Gunduz K, Avsever H, Orhan K. The anatomical and measurement study of rosenmuller fossa and oropharyngeal structures using cone beam computed tomography. Acta Clin Croat. 2022;61:177-84.
21. Takasugi Y, Futagawa K, Konishi T, et al. Possible association between successful intubation via the right nostril and anatomical variations of the nasopharynx during nasotracheal intubation: A multiplanar imaging study. J Anesth. 2016;30:987-93.