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Juvenile angiofibroma of the nasopharynx is one of the typical and common nasopharyngeal tumors. It refers to benign tumors, although it often has a tendency to relapse and spreading growth. It occurs exclusively in boys and youths aged 8 to 25 years. At first, there is difficulty in nasal breathing, usually more than one half of the nose, mucopurulent discharge (Fig. 3.11). At this stage, the patient and his parents may not go to the doctor until sudden nosebleeds occur - a characteristic symptom of juvenile angiofibroma. They are repeated aperiodically, can be so plentiful that they will require emergency care and anterior nasal tamponade. Sometimes, by mistake, such a tumor is mistaken for adenoids and produce an adenotomy, resulting in profuse bleeding that requires immediate posterior nasal tamponade. Blood loss can reach a critical level of up to 1000 ml, when an urgent blood transfusion is necessary. Therefore, with repeated bleeding, adenotomy should be performed under endotracheal anesthesia, when in the event of bleeding, it is not difficult to produce posterior tamponade, and then proceed to remove the tumor. The Denker approach through the maxillary sinus is convenient, when a tumor detected in the nasopharynx and posterior parts of the nasal cavity with a rasp is bluntly separated from its base on the nasopharyngeal arch, which is not always easy. After removal, a posterior tamponade is produced, the tampon is held for 5-7 days due to the possibility of bleeding. Histological examination of the removed tumor is mandatory.
Of the other nasopharyngeal tumors, there are “mixed” tumors - epitheliomas, characterized by slow growth with spreading of the surrounding tissues, which are easily removed because they have a capsule (Fig.
3.12 and 3.13).
Of malignant tumors, it is often melanoma. Tumors of the pharynx are generally more common in men 1.5-7.5 times according to various authors. Of the tonsil tumors, lymphoma or lymphosarcoma should be noted, starting with a symmetrical enlargement of the tonsils, then ulcers with a dense fibrinous coating appear. Tumor growth can spread upward, towards the soft palate with its paresis, necrosis, open nasal, food entering the nasopharynx when swallowed. Cervical lymph nodes are enlarged, moderately painful. Such a tumor is highly radiosensitive and is successfully treated with x-rays.
Pharyngeal cancer has two forms of differentiated cancer: ulcerative and papillomatous (Fig. 3.14). Cancer can affect both the walls of the pharynx and, more often, the tonsils. The ulcer form is characterized by the appearance of early radiating pains due to tumor invasion into the surrounding tissue and early metastasis. The papillomatous form is more rare, develops from papillomas in adults, proceeds superficially, but prone to metastases. Tonsil cancer at an early stage must be differentiated with infectious granulomas - syphilis, tuberculosis, fusospirochetosis.
Low-differentiated tumors (lymphoepitheliomas, reticulocytomas, transitional cell carcinomas, cytoblastomas) are insidious in that their metastasis outstrips the growth of the main tumor, so the tumor itself can take the form of ordinary tonsil hypertrophy, and the cervical lymph nodes are significantly enlarged (Fig. 3.15 and 3.16). The general pattern for the entire ENT oncology is as follows: the diagnosis of tumors is not difficult in the late stages (3 and 4), the treatment is very difficult or hopeless, and the diagnosis in the early stages is very difficult (1-2), the treatment is equally successful.
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- Malignant pharyngeal tumors
The comparative incidence of pharyngeal cancers is high; carcinomas, lymphoepitheliomas, cytoblastomas, sarcomas, reticulocytomas, and mixed tumors are found among them. Men get sick more often than women, usually in middle age. K l and n and with to and to kartin and. The early symptoms of pharyngeal malignant tumors are poor and little characteristic. Light sensations may appear.
- Benign pharyngeal tumors
Benign pharyngeal tumors include fibroma, papilloma, hairy polyp, angioma, neurinoma, neurofibroma, mixed tumors, lipoma, cysts, pharyngeal goiter. More often than others, papillomas and fibromas on the leg are found. Papillomas are usually soft, located on the soft palate and palatine arches, are small in size and, as a rule, bother the patients a little. In some cases, papillomas come from
- TUMOR GROWTH. TUMOR PROGRESSION. TUMOR MORPHOGENESIS. INVASION AND METASTASIS OF MALIGNANT TUMORS. BIOMOLECULAR TUMORS MARKERS. ANTITUMOR IMMUNITY. PARANEOPLASTIC SYNDROMES. BASIC PRINCIPLES OF CLASSIFICATION OF TUMORS. MORPHOLOGICAL FEATURES OF TUMORS FROM EPITELIUM AND TUMORS FROM TISSUES - DERIVATED MESENCHIMES
TUMOR GROWTH. TUMOR PROGRESSION. TUMOR MORPHOGENESIS. INVASION AND METASTASIS OF MALIGNANT TUMORS. BIOMOLECULAR TUMORS MARKERS. ANTITUMOR IMMUNITY. PARANEOPLASTIC SYNDROMES. BASIC PRINCIPLES OF CLASSIFICATION OF TUMORS. MORPHOLOGICAL FEATURES OF TUMORS FROM EPITELIUM AND TUMORS FROM TISSUES - DERIVATIVES
- MESENCHYMAL TUMORS. TUMORS OF MELANINE-FORMING I FABRIC. TUMORS OF THE CENTRAL NERVOUS SYSTEM, BRAIN CELLS AND PERIPHERAL NERVES
MESENCHYMAL TUMORS. TUMORS OF MELANINE-FORMING I FABRIC. TUMORS OF THE CENTRAL NERVOUS SYSTEM, BRAIN CELLS AND PERIPHERAL
- Tumors: definition, nomenclature, classification. Tumor growth and molecular foundations of carcinogenesis. Tumors from the epithelium.
1. The main theories of tumor growth 1. inflammatory 2. dysontogenetic 3. viral genetic 4. chemical carcinogens 5. physical carcinogens 2. Activation mechanisms of cell oncogenes 1. alteration 2. regeneration 3. proliferation 4. amplification 5. point mutation 3. Stages chemical carcinogenesis 1. promotion 2. initiation 3. alteration 4. proliferation 5. tumor progression 4.
- Mesenchymal tumors. Tumors of melanin-forming tissue
Mesenchymal tumors are tumors that develop from mesenchyme derivatives - connective, vascular, muscle, fat, bone, cartilage, synovial membranes, fascia, tendons, aponeurosis. Among benign mesenchymal tumors there are: 1) tumors of fibrous tissue — fibroma and dermatofibroma (histiocytoma); 2) adipose tissue tumors - lipoma, intramuscular
- Pharyngeal injury
In everyday life, internal (through the nose or mouth) pharyngeal injuries of the pharynx by foreign bodies or a pharyngeal burn with chemicals are more often noted, less often thermal. Patients with pharyngeal injuries and burns are subject to hospitalization. First aid consists in washing the pharynx with disinfectant solutions, for burns - with neutralizing liquids (a solution of soda or acetic acid), the introduction of painkillers and
- Pharyngeal neurosis
Violation of the sensitivity of the pharynx of a different nature can occur with many of its diseases and is usually caused by damage to the sensitive innervation of the pharyngeal mucosa or pathology of higher nervous activity. Pharyngeal neurosis is manifested in the form of anesthesia (hyposthesia), hyperesthesia and paresthesia of its mucous membrane. The most common cause of both lowering and rising
The pharynx (pharinx) is an unpaired organ located in the head and neck, is part of the digestive and respiratory systems, is a funnel-shaped tube 12-15 cm long, suspended from the base of the skull. It is attached to the pharyngeal tubercle of the basilar part of the occipital bone, to the pyramids of the temporal bones and to the pterygoid process of the sphenoid bone; at the level of VI-VII cervical vertebrae
The pharynx is a funnel-shaped cavity with muscle walls, starting from the top from the base of the skull and passing below into the esophagus. The pharynx is located in front of the cervical spine. Its back wall is attached to the vertebrae, on the sides it is surrounded by loose connective tissue, and in front it communicates with the nasal cavity, oral cavity and larynx. According to the three cavities,
- PHYSIOLOGY OF THE THROAT
The pharynx has the following functions: swallowing, respiratory, protective, resonant, speech. The swallowing function (according to Magendie) is provided by two acts. Initially, with the approach of a food lump or saliva, the muscles of the amygdala arches (m. Palatoglossus et palatopharyngeus) and the muscles of the root of the tongue contract, pushing the contents further from the oral cavity to the oropharynx. The back muscles are included here.
- Pharyngeal diseases
Anomalies in the development of the pharynx are found in the form of splitting, shortening or lack of soft palate and tongue; these defects are often combined with congenital clefts of the hard palate. As rare anomalies, defects in the palatine arches of the tonsils are observed. Cicatricial deformities of the pharynx. In some serious infectious diseases (scarlet fever, diphtheria), deep lesions of the mucous membrane are observed.
- Pharyngeal wounds
There are wounds of the pharynx external and internal, closed subcutaneous and open with damage to the skin, isolated and combined. In addition, depending on cash availability or lack of perforation, there are wounds penetrating and non-penetrating, in the presence of only an inlet - blind, and if there is an outlet - through. External wounds of the pharynx are divided into cut, punctured, bruised,
- CLINICAL THROAT ANATOMY
The pharynx, pharynx, is the initial part of the digestive tube located between the oral cavity and the esophagus. At the same time, it is also part of the respiratory tube, connecting the nasal cavity or oral cavity with the larynx. Consequently, in the pharyngeal cavity, the digestive and respiratory tract cross. The pharynx has the shape of a funnel-shaped tube flattened in the anteroposterior direction,