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What is Most common presentation of nasopharyngeal carcinoma - and explain in detail?
Ans. is 'a' i.e., Neck nodeo Presenting symptoms and sign of nasopharyngeal carcinoma in order of frequency are :-> Cervical lymphadenopathy (most common) (60-90%) > Hearing loss > Nasal obstruction > Epistaxis > Cranial nerve palsies. CN VI paralysis is the most common of theses > Headache > Earache > Neck pain > Weight loss,o Information in this question :i) Cervical adenopathy (Neck node) Most common presentation of nasopharyngeal carcinoma.ii) Type B tympanogram Indicates serous otitis media, which may be a complication of nasopharyngeal carcinoma due to eustachian tube blockade.o Thus, among the given options, nasopharyngeal carcinoma is the answer of choice.Clinical features of nasophary ngeal carcinomao Symptomatology of nasopharyngeal carcinoma is divided into five main groupsNasal symptomsNasal obstruction, nasal discharge, denasal speech (rhinolalia clausa), episiaxis.Otologic symptomsOtologic symptoms are due to obstruction of eustachian tube.This results in serous or suppurative otitis media. Which causes conductive deafness.Presence of unilateral serous otitis media in adult should raise the suspicion of nasopharyngeal carcinoma.Tinnitus and dizziness may occur.OphthalomoneuroLogical symptomsThese symptoms occur due to spread of tumor to the surrounding regions.Squint and diplopia due to involvement of VP cranial nerve.Ophthalmoplagia due to involvement of IIIrd. IVth &. VIth cranial nerve.Facial pain & reduced corneal sensations due to Vth nerve involvementExophthalmos and blindness due to direct extension into the orbit.Jugular foramen syndrome (IXth, Xth, XIth cranial nerve involvementj due to pressure by enlarged lateral retropharyngeal lymph nodes.Cranial nerve XIth involvement due to extension of growth to hypoglossal canal.Horner's syndrome due involvement of cervical sympathetic chain.Neckmass:-Itisthemnstcommonpresentation(60-90%)Due to cervical lymphadenopathy.Distant metastasisInvolve bone, lung, liver and other sites.