鼻咽腔悪性腫瘍 : 特Yにレ線検査および脳神経症状による病巣診断について

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Thirteen cases of Nasopharyngeal malignant tumor, especially about their early diagnostics by the radiographical and neurological examinations are reported (Tab.1).These thirteen cases are nine in the male and four cases in the female. Aural troubles (deafness, tinnitus, sensations of fullness, autophony, etc.) are the initial symptoms in five cases, nasal troubles (nasal obstraction, epistaxis, etc.) four cases, cranial nerve involvements two cases, the lump of side neck and sore-throat one case (Fig.3).It took 7.8 months on average in our cases to make sure the primary lesions since some initial symptoms appeared. The cranial nerves are involvd in our eight cases, and those details are seven cases in V and VI (Fig.11), five cases in IX (Fig.12), four cases in (Fig.7.8.9.10) and XII (Fig.15), three cases in IV.VII(Fig.17.18) X.XI(Fig.13.14), two cases in II and one case in I and VIII cranial nerve.We observed only one case of Horners syndrome(Fig.16). Through our experiences, the radiographical examinasions, neurological examinations and transpalatal biopsy are emphasized as the diagnostic aids for the intracranial spread of the submucous infiltrative type of nasopharyngeal tumor.The most valuable projection is the axial view by which not only bony erosions of the base of the skull but also the findings of choana are able to be estimated(Fig.21, 22, 23).The frontal and lateral view of the skull also presents soft tissue tumor in the posterior wall of the nasopharynx and bony erosions of atlas, axis and condylus occipitalis, etc(Fig.24, 25, 26).Laminagraphy (Fig.27, 28, 29, 30, 31), contrast nasopharyngography(Fig.32, 33) and cerebral angiography are also valuable in some cases(Fig.34).The modified occipito-mental view is the most fit for observing foramen rotundum and fissura orbitalis superior(Fig.35) and Rheses projection for canalis opticus(Fig.36, 37). Although it is not so difficult to find out the proliferative-type tumor in the nasopharynx because of its nasal and aural troubles.But on the contrary in the submucous infiltrative-type nasopharyngeal tumor is very hard to be diagnosed before complicated with some cranial nerve le. sions, metastatic cervical lymphnodes, etc.As above mentioned, the diagnosis of the sub. mucous infiltrative-type of nasopharyngeal tumor is usually very difficult and besides its prognosis is very poor as compared with prolifelative type tumor, so we used to carry out transpalatal biopsy without any hesitations whenever such sub. mucous infiltrative-type of nasopharyngeal tumor is suspected

鼻咽腔悪性腫瘍 : 特Yにレ線検査および脳神経症状による病巣診断について

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