Page 371 - Flexible Robotics in Medicine

364 Chapter 16

affecting Singaporean males and displays a distinct geographical variation such that NPC
has a higher incidence rate in the Asian region such as China and southeast Asia compared
to the United States and Europe region. There are several ways to diagnose NPC, such as
performing imaging tests of computed tomography, magnetic resonance imaging, or
positron emission tomography (PET) scan to view the affected region in more detail or by
nasopharyngoscopy. Recovery and survival rates of NPC are very high when detected and
treated early. However, as the various diagnostic means are generally nonself-administered
and require a specialized surgeon to perform the test, patients who had recovered from NPC
might not diligently go for follow-up checkups, and hence might suffer from a relapse of
NPC unknowingly until it has progressed to the later and deadlier stages.

Besides the alarming mortality rate, NPC also has adverse social and economic impacts.
NPC patients suffer from a decreased quality of life after treatment, such as impairment in
hearing and swallowing functions [3]. Moreover, patients that underwent radiotherapy
during treatment of NPC could also suffer from radiation-induced brain injury, most of
whom further suffer from depression and anxiety. Diagnosis of the NPC can be through
nasopharyngoscopy. Nasopharyngoscopes fall under the category of ear nose, and throat
(ENT) endoscopes [4]. NPC generally affects people between the ages of 35 55 years [5].
Moreover, after receiving primary treatment, close to 70% of patients suffer from NPC
local relapse with a median relapse interval of 25 months.

The relapsed NPC is wider-more spread and may have metastasized to a distant region, so
self-administering of nasopharyngoscopy for the patient to perform regular self-diagnosis at
his/her convenience can allow for early detection, which will significantly boost chances of
recovery and survival.

16.1.1 Unmet needs

There is a high recurrence rate of NPC of 70% after remission [3]. Therefore it is essential
to regularly monitor for the recurrence of NPC apart from early diagnosis. Due to the
high recurrence rate of NPC in patients, a frequent checkup of the nasopharyngeal region
is required to prevent the NPC from developing into distant metastasis. Other than the
relatively high occurrence of NPC and shorter life expectancy of patients with delayed
treatment, the recurrence rate of NPC also poses as one of the major concerns. The study
has found that about 70% of patients will have a local recurrence of NPC after remission
[3]. As recurrence disease grows deeper into tissues and spreads at a faster rate, there is a
need for early detection of local recurrence.
The current method for diagnosing NPC is the use of nasopharyngoscopy, which examines
the nasal cavity and nasopharynx region using a nasopharyngoscope. The endoscope is
inserted into the patient nose and through the turbinate into the nasopharynx region to