鼻咽癌85例临床特征分析

目的　分析鼻咽癌的临床特征。方法　对 85例鼻咽癌放疗患者进行回顾性分析。结果　 85例鼻咽癌发病年龄高峰 41～ 70岁。病理类型多为鳞癌 ,其中以低分化鳞癌为最多 (80 % )。首发症状主要为颈淋巴结肿大、鼻塞、血涕、头痛 ,其发生率依次列前 4位。治疗时症状发生率依次为颈淋巴结肿大、鼻塞、头痛、血涕、听力减退、耳鸣。 85例中共有 6 5例初诊时被误诊 (76 .5 % )。平均发病至确诊时间 7.85个月。结论　鼻咽癌患者发病年龄偏高 ,临床首发症状复杂 ,初诊时易被误诊     

鼻咽癌早期误诊原因分析

1996年3月～2006年12月收治鼻咽癌患者21例，其中误诊8例，误诊率高达38％。本组患者8例，男7例，女1例，年龄31～72岁，平均60岁。临床表现鼻塞、鼻出血或回吸性血涕等鼻部症状3例，耳鸣、听力减退等耳部症状4例，颈淋巴结肿大6例（其中1例为双侧淋巴结肿大），头痛、眼球运动受限等脑神经症状4例，8例均未发现患者肺、肝、骨骼远处转移病灶。本组鼻咽癌患者2例为单一的颈淋巴结肿大症状，6例同时出现有2～3个部位症状。由于鼻咽癌侵犯部位不同导致患者出现不同的临床表现，按其疾病分别就诊于不同的科室，1例以“神经性头痛”内科治疗，2例分别以“恶性淋巴瘤？、颈部包块待查”外科手术治疗，     

以耳部为首发症状的31例鼻咽癌临床分析

鼻咽癌发病率居耳鼻咽喉科恶性肿瘤之首。由于其原发部位深而隐蔽,不易观察,周围毗邻关系复杂,临床表现各异。常以一侧头痛、回吸性涕血及鼻出血、颈部淋巴结肿大、鼻塞等引起医生警惕,而以耳部症状为首发症状的患者往往未能引起重视而发生误诊或漏诊。但鼻咽癌以耳部症状为首发症状者并不罕见,鼻咽癌患者以耳鸣为初发症状的在23．5％-45．6％之间不等。回顾分析我院以耳部症状为首发症状的鼻咽癌共31例,结果报告如下。     

鼻咽癌66例误诊临床分析

目的：探讨鼻咽癌误诊原因，提高鼻咽癌早期诊断率。方法：分析我院1995年1月-2000年12月被误诊的66例鼻咽癌患者的临床资料。结果：误诊为颈部淋巴结结核，颈部淋巴结炎，渗出性中耳炎，神经性头痛，眶尖综合征，神经性耳鸣等；平均误诊时间为4.2月。结论：鼻咽癌临床表现错综复杂。部位隐蔽，容易误诊，临床医师应提高对本病的认识，遇到不明原因的颈部肿块，头痛，回吸涕带血，复视等症状，在查找病因时均可考虑鼻咽癌的可能。     

131例鼻咽癌临床分析

目的:总结鼻咽癌的临床特点,探讨避免漏诊和误诊的方法,提高诊疗水平。方法:对131例鼻咽癌患者的临床资料进行回顾性分析。结果:回吸涕中带血37例,鼻塞32例,耳鸣、听力下降30例,头痛、面部麻木、复视19例,颈部淋巴结肿大12例,吞咽困难、下咽呛咳1例。结论:鼻咽癌临床表现复杂多变,极易漏诊,误诊或长期延误诊断。了解鼻咽癌临床特点,对提高鼻咽癌的诊疗水平,改善鼻咽癌患者预后,降低鼻咽癌患者死亡率有重要意义。     

鼻咽癌12例临床特征和误诊分析

目的 分析鼻咽癌的临床特征和误诊原因,提高早期诊断率.方法 回顾性分析2008年2月-2010年3月误诊的鼻咽癌患者12例,总结其临床特征并分析其误诊原因.结果 本组患者的首发症状中鼻塞10例,血涕9例,听力减退、鼓室积液等耳部症状6例,头痛6例,面部麻木、感觉异常、饮水呛咳、面瘫等面神经损害4例,颈部淋巴结肿大2例,...     

儿童鼻咽癌5例

鼻咽癌好发于成人，儿童少见。我院于１９８９～１９９３年间曾遇５例儿童鼻咽癌，现报道如下。１　临床资料５例均为男性，其中８岁２人，１１～１３岁各１人。头痛２例，鼻塞２例，面瘫１例，鼻涕带血３例，不规则发热２例。病程３个月～２年不等。卡他性中耳炎３例。颅神经受损３例；颈淋巴结肿大３例，鼻咽部ＣＴ均提示阳性，血中抗ＥＢ病毒（ＰＣＲｅｂ）均阳性。血沉增快５例。病理结果均为鼻咽鳞癌。２　典型病例例１　男，１２岁。自述右侧头痛３月伴面瘫及面部麻木２月。上呼吸道感染后症状加重，头痛向颈、耳内放射。无鼻塞和鼻涕…     

鼻咽癌误诊原因分析(附216例报告)

目的分析鼻咽癌误诊的原因,并就如何减少误诊进行探讨,以提高鼻咽癌患者的生存率。方法对216例鼻咽癌误诊的临床资料进行归纳总结,分析其误诊率、误诊时间、误诊医院级别、误诊的疾病等。结果总误诊率达67.7%(216/319);误诊时间(6.5±2.5)个月;误诊的疾病依次为颈淋巴结结核、颈淋巴结炎、慢性鼻炎鼻窦炎、分泌性中耳炎、偏头痛、鼻息肉、颅内肿瘤、神经性耳鸣、眶尖综合征等;一、二、三级医院误诊率分别为85.6%(185/216)、64.8%(140/216)和34.3%(74/216),一级医院误诊率明显高于二级医院(P<0.001),二级医院误诊率也明显高于三级医院(P<0.01);误诊时间分别为(9.5±4.5)、(6.0±3.5)、(3.0±1.5)个月,一级医院误诊时间明显长于二、三级医院(P<0.01);专科医生与非专科医生的误诊率分别为34.7%(75/216)和65.3%(141/216),非专科医生误诊率明显高于专科医生(P<0.001)。结论鼻咽癌临床表现错综复杂,发生部位隐蔽,容易误诊,临床医师应提高对本病的认识,遇到原因不明的颈部肿块、回吸涕带血、头痛、复视等症状,应常规行鼻咽部检查,以提高该病的早期确诊率。     

以外展神经麻痹为首发症状的鼻咽癌2例报告

鼻咽癌常以回缩涕中带血、鼻塞、耳鸣、耳闷、听力下降以及颈部淋巴结肿大为首发症状,而以外展神经麻痹为首发症状的较为罕见,现报告2例.     

鼻咽癌所致头痛31例误诊分析

本文通过分析３１例以头痛为主要和／或首发临床表现的鼻咽癌患者的误诊情况，对今后减少误诊进行了总结。提出应注意头痛的特点：头痛的伴随症状；注意颈上部淋巴结检查以及反复的鼻咽部检查和活检。     

鼻咽癌患者临床分期的相关因素分析

目的：探讨鼻咽癌患者的临床分期与临床特点及病理类型间的相关性。方法：回顾性分析2016年6月至2021年9月在宁波市鄞州区第二医院住院初次确诊的鼻咽癌患者63例（排除已行放化疗的鼻咽癌患者）,分析其临床分期及性别、年龄、首诊症状、首诊时间、伴发症状、淋巴结转移、肿瘤生长方式、病理类型等特点。结果：63例鼻咽癌患者,其中男49例,女14例,年龄22～82(53.8±1.7)岁。Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期分别为17例（占27.0%）、14例（占22.2%）、29例（占46.0%）和3例（占4.8%）,早期31例,中晚期32例,早期诊断率49.2%。首诊症状按照出现率高低依次为上颈部淋巴结肿大24例（占38.1%）、涕血18例（占28.5%）、鼻塞10例（占15.9%）、耳鸣耳闷8例（占12.7%）、鼻出血和头痛及无症状各1例（均占1.6%）。早期患者首诊时间为（2.4±0.3）个月,中晚期患者首诊时间为（5.4±1.1）个月。有伴随症状的早、中晚期患者占比分别为15例（48.4%）、24例（75%）。经Logistic回归分析,首诊症状为淋巴结肿大或涕血、首诊时间越迟、有伴随症状和淋巴结转移是...     

鼻咽癌放射治疗后复发的外科补救治疗

目的:探讨鼻咽癌放射治疗失败后的手术补救治疗,进一步提高鼻咽癌患者的生存质量和远期生存率。方法:对我科经手术治疗的鼻咽癌放射治疗未控或放射治疗后复发者26例(鼻咽病变13例,颈部病变6例,鼻腔病变4例,耳部病变3例)进行了回顾性分析总结。患者术前接受的放射治疗量为60-70 Gy,部分病人还进行化疗。手术方案:①鼻咽原发灶手术。鼻窦内窥镜下使用鼻窦切割钻、半导体激光、专用双极电凝等进行局部切除;②颈部手术。根据淋巴结转移情况分别进行根治性、改良根治性和选择性颈淋巴结清扫术。③鼻部手术。鼻侧切开+上颌骨部分切除术。④耳部手术。耳后切口扩大乳突根治术。全部患者术后进行了40-50 Gy的补充放疗并进行了2-10年的随访。结果:手术并发症发生率为15.4%(4/26)。术后2年患者均存活。结论:鼻咽癌首选放射治疗,首次放射治疗失败后可进行手术补救,术后可再次放射治疗,有望提高生存率和生活质量。     

Etiological analysis of the sequelae of radiotherapy for nasopharyngeal carcinoma: a follow-up study of 112 cases.

OBJECTIVE: To explore the etiology of the sequelae of radiotherapy for nasopharyngeal carcinoma (NPC) so as to find the possible means for reducing or preventing its occurrence. METHODS: A total of 112 pathologically confirmed patients with nasopharyngeal carcinoma, who had survived for 5 years following the radiotherapy, were included in this study. Sixty-four patients with the primary carcinoma in the nasopharyngeal region received radiotherapy with the radiation field covering the bilateral anterior ear regions, and in the other 48 patients, adjuvent exposure of the anterior nasal region was administered. The metastases in the cervical lymph nodes were exposed to tangential radiation by 40 Gy X-ray followed by approximately 20 Gy vertical electron beam exposure. RESULTS: Limited mouth-opening and dry mouth occurred mostly during the first 2 years after radiotherapy, and hearing loss in the first year. Neck fibrosis tended to increase with the time elapse after the therapy, and posterior cranial nerve damages showed no signs of time-related occurrence. It was found that the occurrence of neck fibrosis, dry mouth and the nerve injuries did not obviously correlate with the dosage of X-ray exposure in the anterior ear regions, while limited mouth-opening and the hearing loss increased with the radiation dosage. The sequelae did not arise from different radiation field selection as adopted in this study. CONCLUSION: The radiation dose should be controlled at around 70 Gy for NPC treatment, and for carcinoma remnant in the nasopharyngeal region, additional dose in the cavity would be appropriate. When the X-ray dose of 65 Gy in the neck region fails to result in satisfactory recession of lymph node metastasis, comprehensive treatment involving multiple modalities should be considered.     

Unusual clinical presentation of nasopharyngeal carcinoma--report of 3 cases

Among head and neck cancers, nasopharyngeal carcinoma has the poorest prognosis because of the primary site's proximity to the base of the skull and multiple vital structures. The presenting symptoms are generally being nasal obstruction, epistaxis, painless cervical lymphadenopathy, etc. Some patients apart from these usual presentations, report with some unusual presentations. Here in this series, 3 patients were presented, one with distant metastasis, one with upper airway obstruction and another with complete visual loss and difficulty in swallowing. They all were treated with combination chemotherapy and external beam radiation.     

儿童鼻咽癌的临床病理学研究

对28例6～12岁的鼻咽癌患者的病理学特点进行了分析。组织学类型以低分化鳞状细胞癌居多,占67.86%,首发症状是颈部淋巴结肿大、鼻出血及头痛等,13例查见鳞状上皮化生。免疫组化角蛋白染色有助于鼻咽癌和其他非上皮肿瘤鉴别诊断。     

Experience with malignant tumours of the maxillary sinus in the Department of Otolaryngology Universiti Kebangsaan Malaysia, Kuala Lumpur

Thirty one cases of malignant tumours of the maxillary sinus presenting to the Department of Otolaryngology, Universiti Kebangsaan Malaysia over a four year period from 1982 to 1986 are reviewed. 18 cases (58.1%) were squamous cell carcinoma while seven cases (22.5%) were Non-Hodgkin's lymphoma. There were four cases (12.0%) of adenoid cystic carcinoma while in two cases (6.5%) the tumours were undifferentiated. Presentation was generally late. Nasal obstruction, facial swelling and epistaxis were the main presenting symptoms. Nasal involvement was found in 61.3% of cases, while 51.6% had involvement of the palate as well. Metastasis to the cervical lymph node were uncommon (6.5%). Surgery and radiotherapy with or without chemotherapy were the main modes of treatment in the management of malignant tumours of the maxillary sinus.     

鼻咽癌1000例临床分析

<正> 鼻咽癌是一种恶性程度较高的常见疾病之一,其发病率居头颈部恶性肿瘤首位。为了进一步搞好鼻咽癌的防治,加深它的认识,大力开展宣传防癌知识,以便早期发现、早期诊断和早期治疗,从而达到提高生存率的目的。     

MRI和CT平扫／增强对鼻咽癌诊断价值的比较

目的探讨磁共振在鼻咽癌诊治中的应用价值。方法分析经病理证实的245例鼻咽癌患者的MRI和CT平扫／增强影像学资料。结果245例鼻咽癌中,MRI平扫及增强显示鼻咽癌侵犯咽旁间隙、口咽、咽后淋巴结、颅底骨质、鼻窦、海绵窦、颅内等的检出率均高于CT,差异有统计学意义（P〈0．05）;平扫时MRI对颈部淋巴结转移检出率高于CT,差异有统计学意义（P〈0．05）,但增强时MRI对颈部淋巴结转移检出率与cT比较差异无统计学意义（P〉0．05）;MRI平扫及增强与CT平扫及增强对鼻咽癌鼻腔侵犯检出率比较差异均无统计学意义（P〉0．05）。结论MRI能够清晰显示鼻咽癌肿块、邻近结构和咽后淋巴结转移等,在鼻咽癌的诊断和放射治疗靶区定位具有重要价值。     

从MRI的表现探讨鼻咽癌生长方式及淋巴结转移的规律

目的　探讨鼻咽癌 (NPC)的生长方式及淋巴结转移的规律。方法　搜集经病理活检证实且检查前未做任何治疗的 83例NPC ,通过MRI影像表现分析NPC的生长模式及淋巴结转移与NPC深层结构侵犯的关系。结果　NPC的 3种生长方式与淋巴结转移的关系无显著性意义 ;颈部淋巴结转移有两侧转移的趋势 ,咽后淋巴结有单侧转移的趋势 ;茎突后间隙受累有较高的颈部淋巴结转移率。结论　MRI可以确切了解NPC的生长方式、侵犯范围、有无淋巴结转移 ,对NPC的分期及放疗计划的制定有重要作用。     

Difficulty in diagnosis of nasopharyngeal carcinoma

Due to difficult anatomical position nasopharyngeal carcinoma (NPC) is always challenging problems both from the diagnostic and therapeutic corner. A 24 years old lady came to our Department of Otolaryngology and Head-Neck Surgery with the complaints of epistaxis, right sided neck swelling, nasal obstruction and headache. On digital palpation Nasopharyngeal mass was found. We took biopsy from nasopharynx under indirect vision but report was not conclusive. Then we did CT scan, nasendoscopy. Nasendoscopy showed bilateral ethmoidal polyp with nasopharyngeal mass. We took biopsy from the nasopharyngeal mass and confirmed the diagnosis.