Contribution of Imaging
Methods to the Diagnosis of Nasopharyngeal Tumours
Čelakovský P., Chrobok V., Brtková J., Dědková J., Růžička J., Dufek Z.
Klinika otorinolaryngologie a chirurgie hlavy a krku LF UK a FN, Hradec Králové, přednosta doc. MUDr. J. Vokurka, CSc. Radiodiagnostická klinika LF UK a FN, Hradec Králové, přednosta doc. MUDr. P. Eliáš, CSc. |
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Summary:
The authors evaluate the contribution of different methods to the diagnosis of nasopharyngeal tumours. Attention is paid in particular to modern imaging methods, i.e. CT and MR. The
authors emphasize the necessity of knowing the anatomy of the particular area for correct reproducibility of results and they present a review of the basic anatomy of the nasopharynx, incl.
relations with neighbouring structures and description of possible directions of the spread of
nasopharyngeal malignities.
The authors evaluate a group of 20 patients with malignities of the nasopharynx and present CT
findings in brief case-records. Based on comparison of results of imaging examinations with
endoscopy and clinical symptomatology, they draw attention to diagnostic pitfalls of nasopharyngeal tumours and recommend an algorithm of examinations for the primary diagnosis and follow
up of patients with an epipharyngeal tumour.
Endoscopy of the nasopharynx remains the basic examination which leads most rapidly and most
easily to the clinical diagnosis. Further examinations such as e.g. audiometry and tympanometry
serve as auxiliary examination methods which may arouse suspicion that a more detailed examination of the nasopharynx is necessary. The main task of imaging should be to assess the extent of the
affliction and TNM classification.
Even in case of negative endoscopy it is useful to make an imaging examination.
- In case of an exudate in the area of the middle ear persisting for several weeks, which developed
without an apparent reason in a patient of risk age and which does not respond to common
treatment.
- In a patient with metastatic affliction of the cervical nodes and unknown primary focus who has
at the same time an exudate in the middle ear.
- In a patient with metastatic affection of the cervical nodes where it does not prove possible to
detect the primary focus during repeated panendoscopic examinations or where the histological
type of tumour and site of metastases indicate the possible origin of the tumourous process in the
nasopharynx.
In the course of dispensary check-up examinations we do not rely only on endoscopic examination
but make after certain time intervals also CT examinations, in particular in tumours which are in
a more advanced stage.
Key words:
computer tomography, magnetic resonance, nasopharyngeal tumours, diagnosis.
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