Performing nasopharyngeal swabs-Guidelines based on an anatomical study

Area of Science:

• Anatomy
• Medical Diagnostics
• Respiratory Medicine

Background:

• Nasopharyngeal swabs are crucial for diagnosing respiratory diseases, including COVID-19.
• Current techniques lack systematic anatomical guidance for safe and effective nasopharyngeal sampling.
• Potential risks include injury to the cribriform plate and olfactory mucosa.

Purpose of the Study:

• To define anatomical prerequisites for successful nasopharyngeal swab insertion.
• To develop a safe and effective procedure for collecting nasopharyngeal samples.
• To minimize risks associated with swab performance.

Main Methods:

• Simulation of 314 nasopharyngeal swabs in 157 human body donors using metal probes and commercial swabs.
• Photo-documentation and measurement of key anatomical parameters.
• Analysis of probe trajectories relative to anatomical landmarks.

Main Results:

• A simple, safe three-step procedure for nasopharyngeal swabbing was developed.
• The proposed method successfully accessed the nasopharynx in all specimens without nasal cavity deformation.
• An alternative widely used method succeeded in less than 50% of cases.
• Risks to the cribriform plate and olfactory mucosa were deemed unlikely but potentially higher with nasal swabs.

Conclusions:

• The study provides crucial anatomical data for optimizing nasopharyngeal swab collection.
• The proposed three-step procedure enhances the success rate and safety of nasopharyngeal sampling.
• Accurate sampling is vital for detecting pathogens like SARS-CoV-2, which target pharyngeal mucosa.