This 78-years old man came for a nasopharyngeal mass biopsy to get material for microbiology. The head and neck surgeon was not comfortable doing this biopsy and so the infectious disease physician asked for a CT guided biopsy.
![](https://www.ctbiopsy.com/content/images/2023/05/image.jpeg)
At the time of the biopsy, the scan showed necrosis / collection anteriorly.
![](https://www.ctbiopsy.com/content/images/2023/05/Screenshot-2023-05-02-at-6.52.24-PM.png)
Which route will you take?
![](https://www.ctbiopsy.com/content/images/2023/05/Screenshot-2023-05-02-at-6.53.17-PM.png)
These are the typical routes available for reference
![](https://www.ctbiopsy.com/content/images/2023/05/Screenshot-2023-05-02-at-6.53.58-PM.png)
These are some of the previous head and neck biopsies discussed on the site for reference.
Case 23: Biopsy of Greater Wing of Sphenoid in a 25-Years Old for Recurrent Adenoid Cystic Carcinoma
25-years old treated with h/o adenoid cystic carcinoma palate with intra-orbital mass involving sphenoid bone, which was biopsied.
![](https://www.ctbiopsy.com/content/images/2021/04/Presentation1-2.jpg)
Case 24: Oropharyngeal / Parapharyngeal Mass Biopsy
68-years old with a left parapharyngeal- oropharyngeal mass. The CT guided biopsy was simple. The video explains safe routes and discusses two papers.
![](https://www.ctbiopsy.com/content/images/2021/04/Presentation1-3.jpg)
Case 78: Lateral Pharyngeal / Retropharyngeal Lesion Biopsy with a Paramaxillary Approach
Lateral Pharyngeal / Retropharyngeal Lesion Biopsy with a Paramaxillary Approach
![](https://www.ctbiopsy.com/content/images/2022/02/Presentation1.jpg)
What would you do?
The discussion video follows.