Hoʻomaka nā kanesa Nasopharyngeal ma hope o nā ihu ihu, mai ka ʻāpana ma luna aʻe o ka palahalaha a hiki i ka ʻaoʻao luna o ka ʻāʻī. ʻO ka poʻe me ke ʻano e hoʻomohala pinepine i nā nodule i ka ʻāʻī, loaʻa paha i kahi ʻano o ka piha a ʻeha paha i nā pepeiao, a me ka nalo ʻana o ka lohe. ʻO nā ʻōuli ma hope e pili ana i ka ihu ihu, ka ihu, ka helehelena a me ka helu. Pono ʻia kahi biopsy e hana i ke kuhi a me nā hōʻike kiʻi (CT, MRI, a i ʻole PET) e nānā ʻia i ka nui o ka maʻi ʻaʻai. Hoʻokumu ʻia ka mālama ʻana ma ka radiotherapy a me ka chemotherapy a, ʻē, ma ke ʻoki.

ʻO ka maʻi ʻaʻai Nasopharyngeal, i kapa ʻia ʻo nasopharynx, cavum a i ʻole epipharynx, he maʻi ʻaʻai ia no ka epithelial, e ulu ana i loko o nā hunaola o ka ʻaoʻao luna o ka pharynx, ma hope o nā ʻaoʻao ihu, mai ka ʻāpana i luna mai ka pā palule a i ka ʻaoʻao kiʻekiʻe o ka ʻāʻī. ʻO ka hapanui o nā maʻi ʻino o ka nasopharynx he carcinomas squamous cell, ʻo ia hoʻi ke hoʻomohala i nā hunaola squamous e uhi ana i ka nasopharynx.

ʻOiai hiki ke ulu i ka maʻi ʻaʻai nasopharyngeal i kēlā me kēia makahiki, pili nui ia i ka poʻe ʻōpio a me nā mea maʻi ma mua o 50 mau makahiki. ʻOiai ʻoi aku ka laha ʻole i ʻAmelika Hui Pū ʻIa a me ʻEulopa Komohana, he mea maʻamau ia ma ʻAsia a ʻo ia kekahi o nā maʻi ʻaʻai ʻoi loa ma waena o nā poʻe kū mai Kina i United. ʻO nā mokuʻāina, ʻo ia hoʻi nā kūpuna o Kina Hema a me Hema. -Asia. He kakaikahi ka maʻi ʻaʻai Nasopharyngeal ma Palani me ka liʻiliʻi ma mua o hoʻokahi hihia no 100 poʻe. Hoʻopilikia pinepine ʻia nā kāne ma mua o nā wahine.

Ua hoʻokaʻawale ʻia nā tumors epithelial Nasopharyngeal e ka World Health Organization ma muli o ke kēkelē o ka hoʻokaʻawale ʻana i nā ʻino malignant:

• ʻAno I: hoʻokaʻawale keratinizing squamous cell carcinoma. Laʻa ʻole, ʻike ʻia ia ma nā wahi o ka honua me nā hanana haʻahaʻa loa;
• ʻAno II: ʻokoʻa-keratinizing squamous cell carcinoma (35 a 40% o nā hihia);
• ʻAno III: Ka maʻi kanesa Undreadenciated o Nasopharyngeal ʻAno (UCNT: Carcinoma Undifferenciated o Nasopharyngeal ʻAno). Hōʻike ia 50% o nā hihia ma Palani, a ma waena o 65% (ʻAmelika Hema) a me 95% (Kina) o nā hihia;
• ʻO Lymphomas e hōʻike ana ma kahi o 10 a 15% o nā hihia.

ʻO nā maʻi ʻino nasopharyngeal ʻē aʻe:

• carenoomas cystic adenoid (cylindrome);
• huelo huikau;
• adenocarcinomas;
• fibrosarcomas;
• osteosarcoma;
• chondrosarcomas;
• nā melanoma.
  

Ua hōʻike ʻia he mau mea pili i ke kaona a me ka lawena e carcinogenic no nā kānaka e pili ana i ka maʻi ʻaʻai nasopharyngeal.

• ʻO ka maʻi Epstein-Barr: ʻo kēia maʻi mai ka ʻohana herpes e hoʻopili i nā lymphocytes o ka ʻōnaehana pale a me kekahi mau pūnaewele i ka uhi o ka waha a me ka pharynx. Kū pinepine ka maʻi maʻi i ka wā kamaliʻi a hiki ke hōʻike ʻia ma ke ʻano he maʻi respiratory respiratory a i ʻole mononucleosis infectious, kahi maʻi akahai o ka wā kamaliʻi a me ka ʻōpio. Ma mua o 90% o ka poʻe ma ka honua holoʻokoʻa i loaʻa i kēia maʻi, akā ʻoi aku ka maikaʻi ʻole. ʻO kēia no ka mea ʻaʻole nā ​​kānaka āpau me ka maʻi Epstein-Barr e hoʻomōhala i ka maʻi ʻaʻai nasopharyngeal;
• ka ʻai ʻana i nā nui o nā iʻa i mālama ʻia a hoʻomākaukau ʻia paha i ka paʻakai, a i ʻole nā ​​meaʻai i mālama ʻia e nā nitrites: hana ʻia kēia ʻano o ka mālama a hoʻomākaukau paha i nā wahi he nui o ka honua, a ma Asia Hema hoʻi. Eia nō naʻe, ʻaʻole i hoʻokumu paʻa ʻia ke ʻano e hoʻopili nei i kēia ʻano meaʻai i ka hoʻokumu ʻia ʻana o ka maʻi ʻaʻai nasopharyngeal. Hāʻawi ʻia i ʻelua kuhiakau i mua: ka hoʻokumu ʻana o nitrosamines a me ka hoʻoulu hou ʻana o ka maʻi Epstein-Barr;
• puhipaka: hoʻonui ka makaʻi me ka nui a me ka lōʻihi o ka ʻai paka ʻana;
• formaldehyde: hoʻolaha ʻia i ka 2004 ma waena o nā mea carcinogenic i hōʻoia ʻia i loko o nā kānaka no ka maʻi ʻaʻai o ka nasopharynx. Hōʻike ka formaldehyde i kahi ʻoi aku i hoʻokahi haneli mau ʻoihana a me nā ʻano ʻāpana o ka hana: kauka holoholona, ​​nā mea hoʻonani, nā lāʻau lapaʻau, nā ʻoihana, nā mahiʻai, a pēlā aku.
• lepo lepo: hoʻoili ʻia i ka wā o ka hana ʻana o ka wahie (ke kuʻi ʻana, ka hana ʻili ʻana, ka wili ʻana), ka mīkini ʻana o ka lāʻau ʻalalā a i ʻole nā ​​panā lāʻau i kūkulu hou ʻia, ka lawe ʻana i nā ʻāpana a me nā wahī i hopena ʻia mai kēia mau hoʻololi ʻana, hoʻopau ʻana i nā lako (ginning). Hiki ke hanu ʻia kēia lepo lepo lāʻau, keu hoʻi e ka poʻe i hōʻike ʻia i ka papa o kā lākou hana.

ʻO nā mea ʻē aʻe e ʻike ʻia no ka maʻi ʻaʻai nasopharyngeal i kuhi ʻia i ke ʻano o ka ʻike i kēia manawa.

• puhi pahi;
• ʻAlekohola inu;
• ka hoʻohana ʻana i ka ʻulaʻula a i ʻole ka meaʻai i hana ʻia;
• maʻi me ka papillomavirus (HPV 16).

Ua ʻike ʻia kekahi kumu pilikia kūpilikiʻi e kekahi mau noiʻi.

ʻO ka hapa nui o ka manawa, pālahalaha mua ka maʻi ʻaʻai nasopharyngeal i nā pūnana lymph, e hopena ana i nā nodule palpable i ka ʻāʻī, ma mua o nā ʻōuli ʻē aʻe. I kekahi manawa hiki i ka keakea mau ʻana o ka ihu a i ʻole nā ​​paipu eustachian ke kumu o ka piha a ʻeha paha i nā pepeiao, a me ka nalo ʻana o ka pepeiao, ma ka ʻaoʻao hoʻokahi. Inā kāpae ʻia ka Tube Eustachian, hiki i ka wai effusion ke kūkulu i loko o ka pepeiao waena.

Loaʻa paha i ka poʻe me ka maʻi:

• he helehelena pehu;
• ka ihu ihu o ka pā a me ke koko;
• epistaxis, ʻo ia hoʻi, nā ihu ihu;
• ke koko i ka lihi;
• he ʻāpana lolo o ka maka a i ʻole ka maka;
• cermph lymphadenopathy.

No ke kuhi ʻana i ka maʻi ʻaʻai nasopharyngeal, nānā mua ke kauka i ka nasopharynx me ke aniani kūikawā a i ʻole ka paipu nānā lahilahi, maʻalahi, i kapa ʻia he endoscope. Inā loaʻa kahi tumo, aia kahi kauka i kahi biopsy nasopharyngeal i hana ʻia, kahi e lawe ʻia ai kahi mea kiko a nānā ʻia ma lalo o kahi microscope.

Hana ʻia kahi scan tomography compute (CT) o ka poʻo iwi poʻo a me nā kiʻi resonance magnet (MRI) o ke poʻo, nasopharynx, a me ke kumu o ka iwi poʻo e nānā i ka nui o ka maʻi ʻaʻai. Hana pinepine ʻia kahi scan tomography emission positron (PET) e loiloi i ka nui o ka maʻi ʻaʻai a me nā lymph node i ka ʻāʻī.

Hoʻonui maikaʻi ka hoʻomaʻamaʻa mua i ka wānana no ka maʻi ʻaʻai nasopharyngeal. Ma kahi o 60-75% o ka poʻe me ka maʻi ʻaʻai mua i loaʻa kahi hopena maikaʻi a ola no 5 mau makahiki ma hope o ka hōʻoia ʻana.

E like me nā kanesa ENT āpau, ua kūkākūkā ʻia nā ʻano ʻokoʻa ʻē aʻe a me ke kaʻina hana lapaʻau i ka CPR i mea e hāʻawi aku ai i ka mea maʻi i kahi polokalamu lapaʻau pilikino. Lawe ʻia kēia hālāwai i mua o nā mea hana like ʻole e pili ana i ka mālama ʻana o ka mea maʻi.

• kauka lāʻau lapaʻau;
• radiothérapeute;
• ʻākōlika;
• radiologist;
• psychologist;
• anatomopathologiste;
• kauka niho

Ma muli o kā lākou topography a me ka hoʻonui kūloko, ʻaʻole hiki i nā maʻi ʻōpala nasopharyngeal i ka lāʻau ʻoki lāʻau. Mālama pinepine ʻia lākou me ka chemotherapy a me ka radiotherapy, a ukali pinepine ʻia e ka chemotherapy adjuvant:

• chemotherapy: hoʻohana ākea, no ka mea, ʻo nā kanulau nasopharyngeal he mau tumo chemosensitive. ʻO nā lāʻau lapaʻau e hoʻohana ākea nui ʻia, ʻo ia ka bleomycin, epirubicin a me cisplatin. Hoʻohana hoʻokahi ʻia ʻo Chemotherapy a i ʻole me ka radiotherapy (concomitant radiochemotherapy);
• ka lāʻau radiation radiation kūwaho: mālama i nā tumo a me nā wahi lymph node;
• radiotherapy kūlike me ka ikaika modulation (RCMI): ʻae i ka hoʻomaikaʻi ʻana i ka uhi dosimetric maʻi puʻupuʻu me ka mālama maikaʻi ʻana o nā hanana olakino a me nā wahi i ka makaʻu. He mea nui ka loaʻa o ka toxin salivary ke hoʻohālikelike ʻia i ka irradiation maʻamau a me ka maikaʻi o ke ola i hoʻomaikaʻi ʻia i ka wā lōʻihi;
• brachytherapy a i ʻole ke hoʻonohonoho ʻana i kahi implant radioactive: hiki ke hoʻohana ʻia ma ke ʻano he suplement ma hope o ka irradiation kūwaho i nā piha piha a i ʻole he catch-up i ka hanana o ka hoʻi hou ʻana o kahi superficial.

Inā hōʻike hou ka tumo, hana hou ʻia ka radiation radiation a i ʻole, i nā hanana kikoʻī loa, e hoʻāʻo ʻia ke ʻoki. He paʻakikī kēia akā no ka mea maʻa mau ka lawe ʻana i kahi ʻāpana o ke kumu o ka iwi poʻo. Hana ʻia ia i kekahi manawa ma o ka ihu e hoʻohana ana i ka endoscope.