Head and Neck A9


Nasopharyngeal Carcinoma

Nasopharyngeal carcinoma is the commonest type of cancer that develops in the nasopharynx. Risk factors for nasopharyngeal carcinoma include:

  • Chinese ethnicity
  • Male
  • Diets with high salt intake
  • Cured meats
  • Fish (common in parts of Asia)
  • EBV infection
  • Family history
  • Tobacco smoking
  • Alcohol.

Nasopharyngeal carcinoma can present with:

  • Symptoms of eustachian tube obstruction (hearing loss, tinnitus, otalgia and/or sensation of aural fullness)
  • Nasal obstruction (blocked nose, facial pain)
  • Epistaxis
  • Glue ear
  • Symptoms which are usually unilateral.

In patients with high suspicion of nasopharyngeal carcinoma (or any head and neck cancer), a full ENT examination is warranted, and you must inspect the post nasal space with flexible nasoendoscopy to identify/rule out a mass. In a primary care setting, the patient must be referred to ENT urgently.

If there is a mass, biopsy is required, and depending on the biopsy result, further imaging and histology for staging and grading of the cancer will be necessary. Treatment options include chemotherapy, radiotherapy and surgery, and the case will be discussed in the multidisciplinary team meeting to decide on the best management plan.

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