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Sinus Surgery - ENT Carolina - Gastonia, Shelby, Belmont
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Tumorile de cavum
Cancerul de cavum se refera la cancerul de nazofaringe (rinofaringe). Cancerul de
cavum este un cancer rar comparativ cu alte tipuri de cancere (s�n, colon, prostata
etc); este un cancer mai frecvent �nt�lnit �n Asia si Africa de Nord, �n Statele
Unite ale Americii, �n schimb, este relativ rar (aproximativ 2900 de persoane
diagnosticate �n fiecare an). [1]
Anatomie
Faringele este organul la nivelul caruia calea respiratorie se �ncruciseaza cu
calea digestiva. Rinofaringele reprezinta etajul superior al faringelui, are o
forma cuboidala si este constituit din 6 pereti: 2 pereti laterali, unde se gasesc
orificiile faringiene ale trompei lui Eustachio si fosetele Rosenmuller, un perete
inferior, locul de comunicare cu bucofaringele, un perete anterior, prin care
comunica cu fosele nazale, un perete posterior si un perete superior, unde se
gaseste amigdala faringiana Lushka [2].
Factori de risc
Fumatul
Fumatul reprezinta unul din principalii factori de risc pentru cancerele de cap si
g�t (printre care si carcinomul nazofaringian). Fumatul pasiv creste, de asemenea,
riscul de carcinom nazofaringian.
Alcoolul
Consumul cronic de alcool creste riscul de aparitie al cancerului de nazofaringe.
Exista un risc �nca si mai mare �n cazul sunt prezenti ambii factori de risc:
alcool si fumatul; acest risc este �nsa mai mic dec�t �n cazul altor tipuri de
cancere de cap si g�t.
Clasificare
�n rinofaringe se pot dezvolta mai multe tipuri de tumori maligne, �nsa tipul cel
mai frecvent este carcinomul nazofaringian scuamos nediferentiat. Potrivit OMS,
tumorile de cavum se �mpart �n 3 mari categorii:
Simptome si semne
adenopatii cervicale nedureroase
obstruc?ie nazala
otite medii recurente
afectari ale nervilor cranieni II (manifestari oculare), VIII (manifestari auditive
si vestibulare), IX si XII (tulburari de deglutitie)
cefalee
Rinoscopia
�n perioada de debut, la rinoscopia anterioara nu se deceleaza nicio leziune la
nivelul nazofaringelui. �n perioada de stare, c�nd tumora �ncepe sa creasca �n
dimensiuni, se poate decela o formatiune tumorala moale, vegetanta, nedureroasa (�n
cazul limfoepiteliomului). La palpare, se pot gasi adenopatii cervicale dure,
fixate, nedureroase, uni sau bilaterale.
Diagnosticul pozitiv
Clasificare TNM
Adenopatii
Metastaze
Diagnostic diferential
fibrom nazofaringian (nu este asociat �n general cu adenopatii, nu s�ngereaza)
polip Killian
vegeta?ii adenoide hipertrofice
tuberculoza, goma sifilitica
Tratament
1. Radioterapie
2. Radioterapie urmata de chimioterapie
3. Chirurgie- mai rar, �n cazul adenopatiilor metastatice reziduale
4. Chimioterapie- �n stadiul metastatic (metastaze la distanta)
Chimioterapia combinata cu radioterapia �n doze mari reprezinta tratamentul de
prima intentie pentru carcinomul nazofaringian. Tratamentul chirurgical este
indicat atunci c�nd adenopatiile nu regreseaza complet la radioterapie. Doza si
c�mpul de radioterapie variaza �n functie de pacient (dimensiunea si localizarea
tumorii si a adenopatiilor). Majoritatea cazurilor sunt tratate prin radioterapie
externa �nsa �n unele situatii se pot folosi implante intracavitare sau
interstitiale sau se poate recurge la radioterapie stereotactica.
2. radioterapie fractionata
Exista si alte studii �n curs de desfasurare care urmaresc eficacitatea unor scheme
de tratament: chimioterapie administrata �naintea radioterapiei, chimioterapie
administrata concomitent cu radioterapia si chimioterapie adjuvanta dupa
tratamentul radioterapic.
2. radioterapie frac?ionata
4. chimioterapie
Prognostic
Anatomie
Faringele este organul la nivelul caruia calea respiratorie se incruciseaza cu
calea digestiva. Rinofaringele reprezinta etajul superior al faringelui, are o
forma cuboidala si este constituit din 6 pereti: 2 pereti laterali, unde se gasesc
orificiile faringiene ale trompei lui Eustachio si fosetele Rosenmuller, un perete
inferior, locul de comunicare cu bucofaringele, un perete anterior, prin care
comunica cu fosele nazale, un perete posterior si un perete superior, unde se
gaseste amigdala faringiana Lushka [2].
Factori de risc
Fumatul
Fumatul reprezinta unul din principalii factori de risc pentru cancerele de cap si
gat (printre care si carcinomul nazofaringian). Fumatul pasiv creste, de asemenea,
riscul de carcinom nazofaringian.
Alcoolul
Consumul cronic de alcool creste riscul de aparitie al cancerului de nazofaringe.
Exista un risc inca si mai mare in cazul sunt prezenti ambii factori de risc:
alcool si fumatul; acest risc este insa mai mic decat in cazul altor tipuri de
cancere de cap si gat.
Clasificare
In rinofaringe se pot dezvolta mai multe tipuri de tumori maligne, insa tipul cel
mai frecvent este carcinomul nazofaringian scuamos nediferentiat. Potrivit OMS,
tumorile de cavum se impart in 3 mari categorii:
Simptome si semne
adenopatii cervicale nedureroase
obstructie nazala
otite medii recurente
afectari ale nervilor cranieni II (manifestari oculare), VIII (manifestari auditive
si vestibulare), IX si XII (tulburari de deglutitie)
cefalee
Rinoscopia
In perioada de debut, la rinoscopia anterioara nu se deceleaza nicio leziune la
nivelul nazofaringelui. In perioada de stare, cand tumora incepe sa creasca in
dimensiuni, se poate decela o formatiune tumorala moale, vegetanta, nedureroasa (in
cazul limfoepiteliomului). La palpare, se pot gasi adenopatii cervicale dure,
fixate, nedureroase, uni sau bilaterale.
Diagnosticul pozitiv
Clasificare TNM
Adenopatii
Metastaze
Diagnostic diferential
Tratament
1. Radioterapie
2. Radioterapie urmata de chimioterapie
3. Chirurgie- mai rar, in cazul adenopatiilor metastatice reziduale
4. Chimioterapie- in stadiul metastatic (metastaze la distanta)
Chimioterapia combinata cu radioterapia in doze mari reprezinta tratamentul de
prima intentie pentru carcinomul nazofaringian. Tratamentul chirurgical este
indicat atunci cand adenopatiile nu regreseaza complet la radioterapie. Doza si
campul de radioterapie variaza in functie de pacient (dimensiunea si localizarea
tumorii si a adenopatiilor). Majoritatea cazurilor sunt tratate prin radioterapie
externa insa in unele situatii se pot folosi implante intracavitare sau
interstitiale sau se poate recurge la radioterapie stereotactica.
2. radioterapie fractionata
2. radioterapie fractionata
4. chimioterapie
Prognostic
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MANUAL OF TEMPORAL BONE DISSECTION
II
III
MANUAL OF TEMPORALBONE DISSECTION
by
M. Barbara
Kugler Publications / The Hague / The Netherlands
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Master Techniques in Rhinoplasty (2011)
Uploaded by Meghan Jones on Oct 20, 2014
surgical technique in rhinoplastyFull description
Copyright: � All Rights Reserved
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Revealing the Skin I'm In: The Naked Truth About 'Nip and Tuck' Plastic Surgery
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The Ugly Truth About Plastic Surgery
The Good Boob Bible
The Good Boob Bible: Your Complete Guide to Breast Augmentation Surgery
Breast Augmentation
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