Waldron J, Van Hasselt C A, Wong K Y
Division of Otorhinolaryngology, Prince of Wales Hospital, Chinese University of Hong Kong.
Head Neck. 1992 Jan-Feb;14(1):24-7. doi: 10.1002/hed.2880140106.
Flexible and rigid endoscopes allow good visualization of the nasopharynx using local anesthesia, and permit biopsies to be taken under direct vision. Little information is available on the accuracy of biopsies taken using local anesthesia, and general anesthesia is usually recommended for evaluation and biopsy of the nasopharynx to avoid missing small or submucosal lesions. We report the results from 260 patients biopsied using local anesthesia (188) and general anesthesia (72). All biopsies were taken using large nasal biopsy forceps under direct vision. The sensitivity of this technique in diagnosing nasopharyngeal carcinoma was 95.1% using local anesthesia and 95.6% using general anesthesia. We suggest that general anesthesia is rarely necessary for definitive biopsy of the nasopharynx. In the majority of patients, an accurate diagnosis can be obtained using large biopsy forceps under direct vision using local anesthesia.
软性和硬性内窥镜在局部麻醉下可很好地观察鼻咽部，并能在直视下进行活检。关于局部麻醉下活检的准确性，目前可用信息较少，通常建议采用全身麻醉来评估和活检鼻咽部，以避免遗漏小的或黏膜下病变。我们报告了260例患者的活检结果，其中188例采用局部麻醉，72例采用全身麻醉。所有活检均在直视下使用大型鼻活检钳进行。该技术诊断鼻咽癌的敏感性在局部麻醉下为95.1%，在全身麻醉下为95.6%。我们认为，鼻咽部确定性活检很少需要全身麻醉。在大多数患者中，使用大型活检钳在局部麻醉下直视操作即可获得准确诊断。
