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Benign tumors of the nasopharynx: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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The most common benign tumors of the nasopharynx of the papilloma and juvenile (juvenile) angiofibroma.
Papilloma is more often localized on the back surface of the soft palate, less often on the side and back walls of the nasopharynx. The papilloma of this localization is more often met in males. The tumor has a characteristic appearance: it is grayish in color, on a broad base, with a granular surface. Isolated lesions of the nasopharynx appear very rarely. The final diagnosis is based on the histological examination.
Treatment is surgical. The papilloma can be removed with the help of an ultrasound disintegrator, laser beam or sargitron.
Juvenile angiofibroma is one of the most common nasopharyngeal tumors, has locally destroying growth, appears on the basis of the nasopharynx in boys and boys.
Histologically, the tumor consists of connective tissue and vessels of varying degrees of maturity. Vascular elements are located chaotically and are represented by a set of vascular formations with thickened or thinned walls.
The clinical picture is quite typical. The tumor grows relatively quickly. Progressively worse nasal breathing. Along with the difficulty of nasal breathing, the hearing decreases gradually, one at a time, and rarely both. Angiofibroma is characterized by nasal bleeding. As the tumor grows, the intensity and frequency of bleeding increases. From the nasopharynx of angiofibroma penetrates into the nasal cavity and paranasal sinuses, primarily in the sinus of the sphenoid bone. A tumor can cause destruction of the base of the skull and penetrate into its cavity. In this case, the listed symptoms are joined by a headache.
At the back of a rhinoscopy or fibroscopy, a cyanotic, tuberous-dense formation is found on a wide base. Valuable information can be obtained by X-ray examination, in particular CT.
Treatment is surgical. The main difficulty that arises in the performance of surgery for angiofibroma is a profuse, life-threatening bleeding. The methods recommended by some authors for sclerosing the tumor in order to reduce intraoperative bleeding by introducing alcohol or formalin are ineffective. The education of patients for this purpose is also unjustified.
The tumor is removed from the wide external access: a cut is made according to Moore, sometimes with a dissection of the upper lip along the middle line. Preliminarily bandage the outer carotid artery, on the side of the tumor (rarely both external carotid arteries). Preliminary ligation of the external carotid artery leads to a significant decrease in intraoperative blood loss; wide outdoor access provides a radical intervention, and therefore its high efficiency. In recent years, to reduce blood loss, embolization of the leading vessels is carried out.
Neurofibroma, schwannoma, chemodectomy, teratoma, meningeoma and other benign tumors in the nasopharynx appear extremely rarely.
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