Nasal endoscopic examination of patients with nasopharyngeal carcinoma

Nasopharyngeal carcinoma refers to a malignant tumor that occurs on the top and side walls of the nasopharyngeal cavity. It is one of the most common malignant tumors in my country, and its incidence rate ranks first among malignant tumors of the ear, nose and throat. Common clinical symptoms include nasal congestion, blood in mucus, stuffy ears, hearing loss, diplopia and headache. Most nasopharyngeal carcinomas are moderately sensitive to radiotherapy, and radiotherapy is the preferred treatment for nasopharyngeal carcinoma. However, for cases with higher differentiated cancers, later course of the disease, and recurrence after radiotherapy, surgical resection and chemotherapy are also indispensable means. However, before treatment, some examinations are needed to confirm the diagnosis and prescribe the right treatment. Let's take a look at the results of nasal endoscopy for nasopharyngeal carcinoma.

1. Nasal cavity endoscopy: 1. Indirect nasopharyngoscopy: This is a simple, fast and effective examination method; 2. Fiber nasopharyngoscopy: This method is relatively simple, but the observation of the posterior nasal aperture and the anterior wall of the roof is not satisfactory. The posterior nasal aperture, nasal septum, posterior nasal cavity, lateral wall of nasopharynx, Eustachian tube, lateral fossa, back and posterior wall of soft palate can be observed.

2. Clinical examination: In addition to the examination of the nasopharynx, nasal cavity, and oropharynx, the head and face, regional lymph node metastasis, and all body systems must be examined for nasopharyngeal carcinoma. 1. Head and neck examination: The nasal cavity, oropharynx, external auditory canal, tympanic membrane, eye socket, and soft palate should be examined for outward extension of nasopharyngeal carcinoma. 2. Eyes: Common symptoms include decreased or absent vision, exophthalmos, intraorbital masses, and ptosis of the upper eyelid with fixed eyeballs. 3. Cranial nerves: Local extension of nasopharyngeal carcinoma often causes damage to the cranial nerves, which in turn causes various neurological disorders in the head and face.

3. X-ray examination: X-ray examination of nasopharyngeal carcinoma patients can help understand the tumor range and skull base bone destruction, which is helpful for staging nasopharyngeal carcinoma, formulating radiotherapy plans, following up patients and evaluating prognosis. Commonly used X-ray examinations include nasopharyngeal lateral film and skull base film.

4. Radionuclide bone imaging diagnosis: Radionuclide bone imaging diagnosis is a non-invasive and highly sensitive diagnostic method. It is generally believed that the positive coincidence rate of bone scan in diagnosing bone metastasis is 30% higher than that of X-ray film; and lesions can be detected 3-6 months earlier.

5. CT examination: CT examination of nasopharyngeal carcinoma can be used to understand the location of the tumor in the nasopharyngeal cavity, whether the lumen is deformed or asymmetric, and whether the pharyngeal recess is shallow or blocked. In addition, it can also show the invasion outside the nasopharyngeal cavity, such as the nasal cavity, oropharynx, parapharyngeal space, submental fossa, carotid sheath area, pterygopalatine fossa, maxillary sinus, ethmoid sinus, orbit, intracranial cavernous sinus, and whether there is metastasis in the posterior pharyngeal and cervical lymph nodes. Nasopharyngeal endoscopy has outstanding value in the diagnosis of tiny tumors in the cavity, while X-ray films and CT often cannot detect such tiny tumors. However, most of the posterior wall and lateral wall tumors grow submucosal infiltrates, which are difficult to be detected by nasopharyngeal endoscopy, but can be clearly displayed by lateral nasopharyngeal films and CT. CT shows lateral wall tumors more clearly than X-ray films.

6. Type B Ultrasound Examination: Type B Ultrasound Examination has been widely used in the diagnosis and treatment of nasopharyngeal carcinoma. It is simple, non-invasive and well-received by patients. In nasopharyngeal carcinoma cases, it is mainly used to examine the liver, cervical, retroperitoneal and pelvic lymph nodes to understand whether there is liver metastasis, lymph node density, cysticity, etc.