CARCINOMA nasopharynx
Nasopharyngeal carcinoma is a carcinoma in ENT most commonly found. Most patients came to the ENT specialist in a state of late or already an advanced stage.
The case is more in men than women, with an average age of 30-50 years.
Factors that Influence
The cause of nasopharyngeal carcinoma is not known with certainty, but there are some things that allegedly affect the occurrence of carcinoma, ie factors:
1. Racial, and is a common disease in ethnic Chinese.
2. Carcinogenic materials, such as cigarette smoke.
3. Epstein-Barr virus, which is thought to act as a cause of nasopharyngeal carcinoma.
4. Chronic irritation, eg due to chronic nasofaringitis stimulation accompanied by smoke, and alcohol.
5. Hormonal, the presence of high estrogen in the body.
Distribution of nasopharyngeal carcinoma
According to histopathology is (a) well differentiated epidermoid carcinoma with type berkeratin and non-keratin, (b) non-differentiated epidermoid carcinoma (anaplastic carcinoma), transitional type, limfoepitelioma, and carcinoma adenosistik.
According to the forms and how to grow there are 3 types of ulcerative, eksofitik (growing out as polyps) and endofitik (grown under the mucosa, a little bit higher than the surrounding tissue) or commonly called creeping tumor.
Nasopharyngeal carcinoma can be found on Rosenmulleri fossa, around the fallopian Eustachius, the rear wall of the nasopharynx, and the roof of the nasopharynx.
Symptoms
Nasopharyngeal carcinoma raises:
1. Local symptoms, ie symptoms of runny nose in the form of one or both nostrils continually. Mucus can be mixed with blood or pus that smells. Epistaxis can be a little or a lot, and recurrent, can also only a ripple of mixed blood. Rice unilateral or bilateral obstruction occurs if the tumor grows eksofitik. Ear symptoms eg hearing loss, tinnitus or otitis media purulenta.
2. Symptoms due to grow and spread of tumors is expansive, the tumor grew to the front face filling the nasopharynx and close koane obstruction causing symptoms of rice. Down, urgent palate tumors that occur bombans palate mole mole.
Infiltrative nature, upward through the foramen ovale into endokranium, the dura and arise sefalgia great, then be on N. VI, there was diplopia and strabismus.
If the N. V, trigeminal neuralgia occurs with symptoms of severe headache in the face, around the eyes, nose, upper jaw, lower jaw, and tongue. N. III and N. IV occurred oftalmoplegia ptosis and, in advanced cases the tumor will damage N. IX, X, XI, XII.
To the side entrance spasium parafaring tumor, destroying N. IX, X, resulting in paresis mole palate, pharynx, and pharynx with symptoms of regurgitation makananminuman into the pouch of rice, rinolalia aperta, and hoarse voice. If the N. XII, there was deviation of the tongue to the side or swallowing disorders.
3. Symptoms due to metastases via the flow of lymph glands will cause enlargement of the neck (colli tumor) located at the bottom end of the mastoid planum, behind the angle of the mandible, the medial than the upper end of M. Sternokleidomastoid, can be unilateral and bilateral.
4. Symptoms due to metastases via the bloodstream, although rare, will cause distant metastases to the liver, lungs, kidneys, spleen, bones and so forth.
Based on the above symptoms, in nasopharyngeal carcinoma need to recognize the symptoms early and advanced symptoms.
Early symptoms are found when the tumor is still growing within the confines of the nasopharynx, so a local phenomenon caused by the primary tumor (symptoms of nasal and ear symptoms as mentioned above).
Symptoms of information obtained when the tumor has grown beyond the nasopharynx, either metastasis or infiltration of the tumor.
As a guideline, remember that there is a malignant tumor nasopharyngeal if found triad:
A. Colli tumors, symptoms of ear, nose symptoms.
B. Colli tumors, intracranial symptoms (nerve and Mats), symptoms of the nose or ears.
C. Intracranial symptoms, nasal symptoms, ear symptoms.
Diagnosis
Diagnosis of nasopharyngeal carcinoma diagnosis based on clinical symptoms found in both early and advanced symptoms. Anterior and posterior rinoskopi examination showed a tumor in the nasopharynx. Furthermore, to determine the type of tumor biopsy needs to be done and pathology examination. X-rays and CT-scan of the head if need be made to look into the intracranial metastases.
Therapy
1. Radiation
2. Sitostatica
Prognosis
In the early stages of both, patients can live more than 5 years, but at an advanced stage of less than 3 years.
Nasopharyngeal carcinoma is a carcinoma in ENT most commonly found. Most patients came to the ENT specialist in a state of late or already an advanced stage.
The case is more in men than women, with an average age of 30-50 years.
Factors that Influence
The cause of nasopharyngeal carcinoma is not known with certainty, but there are some things that allegedly affect the occurrence of carcinoma, ie factors:
1. Racial, and is a common disease in ethnic Chinese.
2. Carcinogenic materials, such as cigarette smoke.
3. Epstein-Barr virus, which is thought to act as a cause of nasopharyngeal carcinoma.
4. Chronic irritation, eg due to chronic nasofaringitis stimulation accompanied by smoke, and alcohol.
5. Hormonal, the presence of high estrogen in the body.
Distribution of nasopharyngeal carcinoma
According to histopathology is (a) well differentiated epidermoid carcinoma with type berkeratin and non-keratin, (b) non-differentiated epidermoid carcinoma (anaplastic carcinoma), transitional type, limfoepitelioma, and carcinoma adenosistik.
According to the forms and how to grow there are 3 types of ulcerative, eksofitik (growing out as polyps) and endofitik (grown under the mucosa, a little bit higher than the surrounding tissue) or commonly called creeping tumor.
Nasopharyngeal carcinoma can be found on Rosenmulleri fossa, around the fallopian Eustachius, the rear wall of the nasopharynx, and the roof of the nasopharynx.
Symptoms
Nasopharyngeal carcinoma raises:
1. Local symptoms, ie symptoms of runny nose in the form of one or both nostrils continually. Mucus can be mixed with blood or pus that smells. Epistaxis can be a little or a lot, and recurrent, can also only a ripple of mixed blood. Rice unilateral or bilateral obstruction occurs if the tumor grows eksofitik. Ear symptoms eg hearing loss, tinnitus or otitis media purulenta.
2. Symptoms due to grow and spread of tumors is expansive, the tumor grew to the front face filling the nasopharynx and close koane obstruction causing symptoms of rice. Down, urgent palate tumors that occur bombans palate mole mole.
Infiltrative nature, upward through the foramen ovale into endokranium, the dura and arise sefalgia great, then be on N. VI, there was diplopia and strabismus.
If the N. V, trigeminal neuralgia occurs with symptoms of severe headache in the face, around the eyes, nose, upper jaw, lower jaw, and tongue. N. III and N. IV occurred oftalmoplegia ptosis and, in advanced cases the tumor will damage N. IX, X, XI, XII.
To the side entrance spasium parafaring tumor, destroying N. IX, X, resulting in paresis mole palate, pharynx, and pharynx with symptoms of regurgitation makananminuman into the pouch of rice, rinolalia aperta, and hoarse voice. If the N. XII, there was deviation of the tongue to the side or swallowing disorders.
3. Symptoms due to metastases via the flow of lymph glands will cause enlargement of the neck (colli tumor) located at the bottom end of the mastoid planum, behind the angle of the mandible, the medial than the upper end of M. Sternokleidomastoid, can be unilateral and bilateral.
4. Symptoms due to metastases via the bloodstream, although rare, will cause distant metastases to the liver, lungs, kidneys, spleen, bones and so forth.
Based on the above symptoms, in nasopharyngeal carcinoma need to recognize the symptoms early and advanced symptoms.
Early symptoms are found when the tumor is still growing within the confines of the nasopharynx, so a local phenomenon caused by the primary tumor (symptoms of nasal and ear symptoms as mentioned above).
Symptoms of information obtained when the tumor has grown beyond the nasopharynx, either metastasis or infiltration of the tumor.
As a guideline, remember that there is a malignant tumor nasopharyngeal if found triad:
A. Colli tumors, symptoms of ear, nose symptoms.
B. Colli tumors, intracranial symptoms (nerve and Mats), symptoms of the nose or ears.
C. Intracranial symptoms, nasal symptoms, ear symptoms.
Diagnosis
Diagnosis of nasopharyngeal carcinoma diagnosis based on clinical symptoms found in both early and advanced symptoms. Anterior and posterior rinoskopi examination showed a tumor in the nasopharynx. Furthermore, to determine the type of tumor biopsy needs to be done and pathology examination. X-rays and CT-scan of the head if need be made to look into the intracranial metastases.
Therapy
1. Radiation
2. Sitostatica
Prognosis
In the early stages of both, patients can live more than 5 years, but at an advanced stage of less than 3 years.
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