{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T11:24:50Z","timestamp":1773746690213,"version":"3.50.1"},"reference-count":26,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Nasopharyngeal carcinoma diagnosis requires endoscopic biopsy, but intraoperative hemorrhage frequently impairs visualization and compromises tissue sampling quality. This prospective case series evaluated topical tranexamic acid (TXA) as a hemostatic adjunct to improve biopsy conditions in suspected nasopharyngeal malignancy. Methods: Adults (\u226518 years) with clinically\/radiologically suspected nasopharyngeal tumors underwent pre-biopsy laboratory screening and exclusion of thromboembolic risk factors. After topical lidocaine anesthesia, a TXA-soaked cotton pledget was applied to the lesion for 10 min prior to forceps biopsy using 0\u00b0 4 mm endoscopy. Bleeding severity was graded pragmatically (minimal: \u22643 gauze pledgets; moderate: &gt;3 or cauterization). Comparative analyses excluded rare diagnoses (n = 1). Results: Of 40 enrolled patients, 34 underwent biopsy (mean age 58.4 \u00b1 12.3 years). All 34 biopsies (100%) yielded conclusive histopathological diagnoses. Adequate hemostasis was achieved in 97.1% (33\/34), with minimal bleeding in 76.5% and moderate\/massive in 23.5%. Non-keratinizing squamous cell carcinoma (44.1%) showed higher moderate bleeding rates than other diagnoses (Fisher\u2019s exact p = 0.00035). Mean hospitalization was 1.79 \u00b1 1.92 days, uniform across categories. No TXA-related adverse events occurred. Conclusions: Topical TXA provided safe, effective hemostasis during nasopharyngeal biopsy across diverse pathologies, achieving 100% diagnostic adequacy and short hospital stays. Controlled trials comparing TXA versus standard hemostatic techniques are warranted.<\/jats:p>","DOI":"10.3390\/jcm15062275","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:21:41Z","timestamp":1773742901000},"page":"2275","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Topical Tranexamic Acid Application to Facilitate Biopsy Acquisition in Endoscopic Nasopharyngeal Biopsy: A Prospective Case Series Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6089-1466","authenticated-orcid":false,"given":"Haldun","family":"Septar","sequence":"first","affiliation":[{"name":"Department of Otorhynolaryngology, Faculty of Medicine, Ovidius University, 900527 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andra Iulia","family":"Suceveanu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Ovidius University, 900527 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6702-7086","authenticated-orcid":false,"given":"Alina Doina","family":"Nicoara","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Ovidius University, 900527 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihai Victor","family":"Lupascu","sequence":"additional","affiliation":[{"name":"Department of Otorhynolaryngology, Faculty of Medicine, Ovidius University, 900527 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandru Aristide","family":"Alexe","sequence":"additional","affiliation":[{"name":"Department of Otorhynolaryngology, Faculty of Medicine, Ovidius University, 900527 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iulia","family":"Cindea","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Faculty of Medicine, Ovidius University, 900527 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viorel","family":"Gherghina","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Faculty of Medicine, Ovidius University, 900527 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catalin Nicolae","family":"Grasa","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine, Ovidius University, 900527 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0555-526X","authenticated-orcid":false,"given":"Anca Pantea","family":"Stoian","sequence":"additional","affiliation":[{"name":"N.C. Paulescu National Institute of Diabetes, Nutrition and Metabolic Disease, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian Paul","family":"Suceveanu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Ovidius University, 900527 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Wei, X., Chen, B., Wang, Z., Zhao, P., and Duan, X. (2024). Nasopharyngeal cancer risk assessment by country or region worldwide from 1990 to 2019. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-19228-9"},{"key":"ref_2","unstructured":"OECD (2025, December 13). EU Country Cancer Profile\u2014Romania 2025. 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