Radiologic evaluation of the normal adult nasopharynx

Adenoid hypertrophy complicates the radiographic evaluation of the adult nasopharynx. To define the limits of normal soft-tissue thickness of the nasopharynx on the lateral film, I measured the profiles of 2 different groups of adult patients: 60 patients examined by x-ray for trauma who had no sinus disease or nasopharyngeal complaints and 30 patients examined by x-ray who had nasopharyngeal complaints necessitating biopsies. Histologic examinations of the biopsy specimens indicated benign disease, usually caused by an inflammatory process. The asymptomatic group showed a more uniform appearance of the nasopharynx than the symptomatic patients, who had a wide variation in the thickness of the nasopharynx. The symptomatic group manifested nasal and eustachian tube obstruction, frequently associated with serous otitis media. When the soft-tissue thickness of the nasopharynx was correlated with age, nasopharyngeal thickening was unusual in asymptomatic persons older than 30 years. Conversely, persons over 30 with nasopharyngeal thickening were often symptomatic and had biopsies indicating some inflammatory change in the nasopharynx.