| Objectives:To investigate the clinical features of nasopharyngeal carcinoma infilatrating the paranasal sinus,by retrospectively analyzing the clinical data of 145 patients of paranasal sinus invasion in nasopharyngeal carcinomaMethods:From January 2009 to December 2012,145 cases of paranasal sinus involvement of NPC patients who hospitalized to The Affiliated Cancer Hospital of Guangxi Medical University were selected.All cases were proved by pathology,and all of them were performed detailed medical examination,MRI or CT scan of nasopharynx and neck,nasopharynx inspection,nasopharynx tumor biopsies and pathological examination and other relevant examinations before treatment.All patients has been follow-uping to December 2015.The clinical and imaging features,main invasion routes of paranasal sinus involvement were investigated by reading clinical records and imaging data,treatment results and prognostic factors were analysed.Results:(1) The number of cases of which screening diagnosis was paranasal sinus invasion was 145 among 1231 cases of patients with nasopharyngeal carcinoma. The incidence of nasopharyngeal carcinoma infilatrating the paranasal sinus was 15.1%.(2) Among 145 cases, Starting symptoms in nasal symptoms (blood congestion and stuff, etc.) the most common is 116 Patients (80%), followed by ear symptoms (tinnitus, hearing loss, etc.) in 95 patients (65.5%),81 cases (55.9%) have a headache, eye symptoms (double vision, decreased vision, drooping eyelids, etc.) of 40 cases (27.6%), cervical lump in 33 patients (22.8%), facial numbness in 27 cases (18.6%), toothache, or swelling of the gums in 3 patients (2.1%) and those with cancer,2 cases (1.3%).(3) Sinus invaded in CT or MRI images show the sinus wall bone destruction 100%(145 cases), sinus mucosa thickening of 51.7%(75 cases), sinus cavity lump 62.8% are connected to the nasopharyngeal tumor (91 cases),93.8%(136 cases), merging, sinus cavity effusion (38 cases) 26.2%(4) Among the group of all patients,the survival rates of 1 year、2 year、3 year were respectively 94.4%、86.3%、71.3%、The 3-year distance metastatic rate was 19.3%、local recurrence rate was 20.7%.(5)Univariate analysis showed that:the number of cranial nerve injury, with or without chemotherapy, radiotherapy statistically significant (p<0.05), and the age, gender, N stage, histological type, the number of violations of the paranasal sinuses was no significant difference (p>0.05)..Conclusion:(1) The incidence of paranasal sinus involvement was 15.1%,lower than that of other reported in the literature at home and abroad, the incidence level were sphenoid, ethmoid, maxillary, frontal.(2) nasopharyngeal carcinoma infilatrating the paranasal sinus are various and atypical, often causing misdiagnosis or missed diagnosis. Its diagnosis mainly depends on CT or MRI imaging examination, MRI is superior to CT and PET-CT.(3) The numbers of articles of cranial nerve injury, with or without chemotherapy, radiotherapy, were significance prognostic factors for the patients of nasopharyngeal carcinoma infilatrating the paranasal sinus(4) Local recurrence and distant metastasis are the main cause of treatment fails for nasopharyngeal carcinoma infilatrating the paranasal sinus... |
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