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Table 7 Standard anatomic limits of Nasopharynx

From: Technical guidelines for head and neck cancer IMRT on behalf of the Italian association of radiation oncology - head and neck working group

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Anterior

Posterior fourth to third of the nasal cavity and maxillary sinuses (to ensure pterygopalatine fossae coverage)

Posterior

Anterior third of clivus (entire clivus if macroscopic infiltration), retrostyloid space

Lateral

Lateral parts styloid processes (parapharyngeal space)

Cranial

a. Skull base (foramen ovale and rotundum bilaterally must be included for all cases),

 

b. Inferior half sphenoid sinus – anterior half clivus (entire clivus and top sphenoid sinus if macroscopic infiltration or in T4 cases).      For lesions confined to the nasopharynx, the pituitary fossa can be excluded from the irradiated volume [97].

 

c. The cavernous sinus should be included in high risk patients (T3, T4, bulky disease involving the roof of the nasopharynx)

Caudal

Soft palate