Is palatal vault height a determinant for nasopharyngeal carcinoma: A hypothesis?

Although environmental and genetic factors are known for nasopharyngeal carcinoma, the present study is an attempt to provide a hypothesis behind the development of NPC with regards to the anatomical factor, the hypothesis being that patients with a deeper palatal vault tend to have a higher risk of developing nasopharyngeal cancers. The objective of this study was to find out the palatal vault height in patients with nasopharyngeal carcinoma and compare it with the palatal vault height in patients with oral carcinomas. The heights of the palatal vault of 20 consecutive patients with nasopharyngeal carcinoma and 20 patients with carcinoma of the oral cavity (except hard palate) as control were recorded. In addition, in patients with carcinoma of the nasopharynx the height of the palate on the CT scans was measured and correlation between these recordings were calculated. The palatal heights of the nasopharyngeal and oral cancer cohorts were compared using independent sample T test. A strong correlation was observed in the nasopharyngeal cancer cohort between the palatal height measured manually and the radiologically measured height on the CT scans (Pearson Correlation Coefficient - 0.633; p=0.003). The difference in the mean heights of the nasopharyngeal and oral cancer cohorts was statistically significant (p<0.001). Nasopharyngeal cancer patients tend to have a higher palatal vault height compared to those with carcinoma of oral cavity other than hard palate. In such palates with a deep vault, there is increased turbulent air flow leading to increased deposition of air-borne virus/carcinogens. Lingering of these agents may ultimately cause carcinoma of the nasopharynx.