Nasopharynx

The nasopharynx is bordered anteriorly by the nasal choanae and nasal cavities. The roof and posterior wall of the nasopharynx form an arch just below the base of the skull with the sphenoid sinus and the floor of the sella turcica. The postero-superior roof contains the (naso)pharyngeal tonsil. At its lower end in the posterior midline lies a blind recess known as the pharyngeal bursa. The lateral walls of the nasopharynx contain the pharyngeal ostia of the auditory tubes, which are surrounded by small aggregates of lymphoid tissue, the tubal tonsil. The cartilage of the auditory tube protrudes above the ostium and is called the torus tubarius, behind which the Rosenm├╝ller fossa is located. The floor of the nasopharynx is formed by the soft palate and uvula. The anterior and cranial portions of the nasopharynx are lined by respiratory mucosa with ciliated columnar epithelium with goblet cells and foci of metaplastic squamous epithelium. Squamous mucosa predominates in the lower nasopharynx adjacent to the oropharynx. Small seromucinous glands and aggregates of lymphoid tissue are present in the submucosa throughout the nasopharynx as a normal finding without qualifying as "chronic inflammation".

Congenital developmental anomalies of the nasopharynx are rare and include choanal atresias and pharyn-geal stenosis. Bilateral occlusion has been reported in up to 40% of patients with choanal atresias. Bilateral atresias are typically osseous, unilateral atresias are membranous. Pharyngeal stenosis is a paediatric disor der associated with sleep apnoea and other craniofacial anomalies [108, 137]. Far more common are congenital cysts and tumours arising from remnants of embryonic tissue.

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