Přínos zobrazovacích metodpro diagnostiku nádorů nosohltanu

Contribution of ImagingMethods to the Diagnosis of Nasopharyngeal Tumours

The authors evaluate the contribution of different methods to the diagnosis of nasopharyngeal tumours. Attention is paid in particular to modern imaging methods, i.e. CT and MR. Theauthors emphasize the necessity of knowing the anatomy of the particular area for correct reproducibility of results and they present a review of the basic anatomy of the nasopharynx, incl.relations with neighbouring structures and description of possible directions of the spread ofnasopharyngeal malignities.The authors evaluate a group of 20 patients with malignities of the nasopharynx and present CTfindings in brief case-records. Based on comparison of results of imaging examinations withendoscopy and clinical symptomatology, they draw attention to diagnostic pitfalls of nasopharyngeal tumours and recommend an algorithm of examinations for the primary diagnosis and followup of patients with an epipharyngeal tumour.Endoscopy of the nasopharynx remains the basic examination which leads most rapidly and mosteasily to the clinical diagnosis. Further examinations such as e.g. audiometry and tympanometryserve as auxiliary examination methods which may arouse suspicion that a more detailed examination of the nasopharynx is necessary. The main task of imaging should be to assess the extent of theaffliction and TNM classification.Even in case of negative endoscopy it is useful to make an imaging examination.- In case of an exudate in the area of the middle ear persisting for several weeks, which developedwithout an apparent reason in a patient of risk age and which does not respond to commontreatment.- In a patient with metastatic affliction of the cervical nodes and unknown primary focus who hasat the same time an exudate in the middle ear.- In a patient with metastatic affection of the cervical nodes where it does not prove possible todetect the primary focus during repeated panendoscopic examinations or where the histologicaltype of tumour and site of metastases indicate the possible origin of the tumourous process in thenasopharynx.In the course of dispensary check-up examinations we do not rely only on endoscopic examinationbut make after certain time intervals also CT examinations, in particular in tumours which are ina more advanced stage.

Key words:
computer tomography, magnetic resonance, nasopharyngeal tumours, diagnosis.