The Probability of Diagnosis of Nasopharyngeal Carcinoma in Patients with Only Adult-Onset Otitis Media with Effusion

成年人中耳積水發生原因有很多，一般會忽略掉是鼻咽部腫瘤另一方面的表現，因鼻咽癌臨床症狀很多，包括：頸部淋巴腺腫大、鼻塞、流鼻血、單發性或夕發性腦神經麻痺、體重減輕、中耳積水、耳鳴、耳脹、耳痛、病人求診時若出現上述症狀則鼻咽癌不難聯想；若是以單純中耳積水為唯一警覺症狀，實令人容易忽略是鼻咽癌之可能。為了釐清兩者之關係和探求由單純癌之可能。為了釐清兩者之關係和探求由單純成年人中耳積水診斷鼻咽癌之機率，高雄醫覺院耳鼻喉科自1995年12月至1997年2月間診療成年人中耳積水之病例，其中不包括頭頸部疾病和鼻咽癌放射線治療後所造成；共得36名，其中男性20名，女性16名，檢查包括詳情之病史詢問、耳鼻喉局部理學檢查、純音聽力檢查、歐氏管功能檢查、鼓室圖、鼻咽纖維內視鏡，若高度懷疑是鼻咽癌則施予鼻咽部組織病理切片。結果在36名患者中，發現早期鼻咽癌共兩例佔5.6%，兩名患者除了僅僅以中耳積水為唯一警覺症狀而無其他臨床相關症狀而讓人容易聯想診斷出是鼻咽癌；此結果高於國外甚多，可能是因台灣為鼻咽癌之高流行區，所以我們認為在台灣面燇成年人患有不明原因單一中耳積水，必須先排除鼻咽癌之可能性，須相當小心仔細檢查鼻咽部，若高度懷疑鼻咽癌所引起，則必須做鼻咽部之組織病理切片，以期早日發現。

關鍵字

無資料

並列摘要

This study tried to assess the probability of nasopharyngeal carcinoma (NPC) being present in adults with only otitis media with effusion (OME) and evaluate the necessity of nasopharyngeal biopsy in Taiwanese adults with only OME. The clinical features of patients with know OME were analyzed and the incidence of nasopharyngeal carcinoma in adults with only OME was assessed. The clinical features of 36 adults with OME but without other symptoms and signs suggestive of NPC who presented to the Kaohsiung Medical College Hospital Department of Otorhinolaryngology between December 1995 and February 1997 were analyzed. Two of these patients had biopsy-proven non-keratinizing carcinomas. OME was caused by upper respiratory infection in 8 patients (22.2%), chronic paranasal sinusitis in 5 (13.9%), allergic rhinitis in 5 (13.9%), NPC in 2 (5.6%), other etiologies in 5 (13.9%) and by unknown etiologies in 11 (30.5%). The incidence of NPC in adults with OME but no other symptoms and signs suggestive of NPC was 5.6% (2 out of 36 patients). It was higher than other reports because NPC has a high prevalence in Taiwan. Therefore, biopsy of the post-nasal space in adults with only OME when NPC is strongly suspected is necessary for the early diagnosis of NPC in Taiwan. We conclude that Taiwanese adults with only OME for which the cause is unclear should be subjected to an examination and biopsy of the nasopharynx to exclude NPC.

並列關鍵字

otitis media with effusion ； nasopharyngeal carcinoma

國際替代計量

The Probability of Diagnosis of Nasopharyngeal Carcinoma in Patients with Only Adult-Onset Otitis Media with Effusion

全文下載

主題瀏覽