Gomarara reNasopharyngeal rinotanga kuseri kwemhino, kubva pachikamu chiri pamusoro pemukanwa munyoro kusvika kumusoro kwehuro. Vanhu vane chirwere ichi vanowanzoita mapundu mumutsipa, vanogona kunzwa kuzara kana kurwadziwa munzeve, uye kurasikirwa kwekunzwa. Zviratidzo zvepashure zvinosanganisira mhino inomhanya, kuvharika kwemhino, kuzvimba kumeso uye chiveve. Biopsy inodiwa kuita kuti kuongororwa uye kufungidzira bvunzo (CT, MRI, kana PET) inoitwa kuti iongorore kukura kwegomarara. Kurapa kunobva paradiotherapy uye chemotherapy uye, zvakanyanya, pakuvhiya.

Chirwere cheNasopharyngeal, chinonziwo nasopharynx, cavum kana epipharynx, igomarara remu epithelial, rinokura mumasero ekumusoro kwe pharynx, kuseri kwemhino, kubva pachikamu chepamusoro kubva pamuromo munyoro kusvika kumusoro huro. Zvirwere zvegomarara zvenasopharynx zvinonzi squamous cell carcinomas, zvinoreva kuti vanokura mumaseru esquamous akavhara nasopharynx.

Kunyange zvazvo kenza yenasopharyngeal inogona kukura pazera ripi neripi, inonyanya kubata vechidiki nevarwere vanopfuura makore 50. Kunyange zvazvo isingawanzoitiki muUnited States neWestern Europe, inowanikwa muAsia uye ndeimwe yekenza yakajairika pakati pevaChinese vanoenda kuUnited States. States, kunyanya idzo dzeSouth China neSouthern descent. -Asian. Kenza yeNasopharyngeal haiwanzo muFrance ine nyaya isingasviki imwe pavagari ve100. Varume vanobatwa zvakanyanya kupfuura vakadzi.

Nasopharyngeal epithelial tumors yakarongedzerwa neWorld Health Organisation zvichibva padanho rekusiyaniswa kwemasero akashata:

• Type I: kusiyanisa keratinizing squamous cell carcinoma. Kashoma, inoonekwa kunyanya munzvimbo dzepasirese dzine zviitiko zvakaderera;
• Rudzi rwechipiri: kusiyanisa kusina-keratinizing squamous cell carcinoma (35 kusvika ku40% yezviitiko);
• Rudzi rwechitatu: Undifferenciated Carcinoma yeNasopharyngeal Type (UCNT: Undifferenciated Carcinoma yeNasopharyngeal Type). Inomiririra 50% yematambudziko muFrance, uye pakati pe65% (North America) uye 95% (China) yematambudziko;
• Lymphomas inomiririra inenge 10 kusvika ku15% yematambudziko.

Mamwe kenza nasopharyngeal anosanganisira:

• adenoid cystic carcinomas (cylindromes);
• mamota akasanganiswa;
• adenocarcinomas;
• fibrosarcomas;
• osteosarcomas;
• chondrosarcoma;
• melanoma.
  

Zvakati wandei zvakatipoteredza uye hunhu zvinhu zvakaratidzwa kuve carcinogenic kuvanhu zvine chekuita nekenza yenasopharyngeal:

• Epstein-Barr virus: hutachiona uhu hunobva kumhuri yeherpes hunokanganisa ma lymphocytes e immune system uye mamwe masero mumucheka wemuromo uye pharynx. Utachiona hunowanzoitika muhuduku uye hunogona kuratidza sechirwere chekufema turakiti kana infectious mononucleosis, chirwere chinyoro chehuduku uye kuyaruka. Pamusoro pe90% yevanhu pasi rose vakabatwa nehutachiona uhu, asi kazhinji hahukuvadzi. Izvi zvinodaro nekuti havasi vanhu vese vane hutachiona hweEpstein-Barr vanokura kenza yepanasopharyngeal;
• kushandiswa kwehove dzakawanda dzakachengetwa kana kugadzirirwa mumunyu, kana yezvokudya zvakachengetedzwa nenzira ye nitrites: iyi nzira yekuchengetedza kana kugadzirira inoitwa munzvimbo dzakawanda dzepasi, uye kunyanya muSouth-East Asia. Zvisinei, nzira inobatanidza rudzi urwu rwezvokudya pakuumbwa kwekenza yenasopharyngeal haisati yanyatsosimbiswa. Mafungiro maviri akaiswa mberi: kuumbwa kwe nitrosamines uye reactivation yeEpstein-Barr virus;
• kusvuta: njodzi inowedzera nehuwandu uye nguva yekushandiswa kwefodya;
• formaldehyde: yakarongedzwa muna 2004 pakati pezvinhu zvinokonzeresa zvinoratidzwa muvanhu negomarara renasopharynx. Kuratidzwa kune formaldehyde kunoitika munzvimbo dzinopfuura zana dzehunyanzvi uye dzakasiyana siyana zvikamu zvezviitiko: veterinary, cosmetics, mushonga, maindasitiri, zvekurima, nezvimwe.
• guruva rehuni: rinobudiswa panguva yekushanda kwehuni (kutema, kusaha, kugaya), kugadzira matanda ane rough kana mapuranga akagadziridzwa, kutakura machipisi uye sawdust inokonzerwa nekushandurwa uku, kupera kwefenicha (ginning). Iri guruva rehuni rinogona kufemerwa, kunyanya nevanhu vanofumurwa mukati mebasa ravo.

Zvimwe zvengozi zvegomarara renasopharyngeal zvinofungidzirwa mune yazvino mamiriro eruzivo:

• passive kusvuta;
• Kunwa doro;
• kushandiswa kwenyama tsvuku kana yakagadzirwa;
• utachiona hwepapillomavirus (HPV 16).

A genetic risk factor inoonekwawo nezvimwe zvidzidzo.

Kazhinji yenguva, kenza yenasopharyngeal inotanga kupararira kumalymph nodes, zvichiita kuti pave nemanodule mumutsipa, pamberi pezvimwe zviratidzo. Dzimwe nguva kuvharidzirwa kunoramba kuripo kwemhino kana eustachian tubes kunogona kukonzera kunzwa kwekuzara kana kurwadziwa munzeve, pamwe nekunzwa kurasikirwa, kune rumwe rutivi. Kana iyo eustachian chubhu yakavharwa, kubuda kwemvura kunogona kuungana mukati kwenzeve.

Vanhu vane chirwere ichi vanogonawo kuva ne:

• chiso chakazvimba;
• mhino inoyerera yepus neropa;
• epistaxis, kureva, kubuda ropa mumhino;
• ropa mumate;
• chikamu chakaoma mitezo chechiso kana ziso;
• cervical lymphadenopathy.

Kuti aongorore kenza yenasopharyngeal, chiremba anotanga aongorora nasopharynx negirazi rinokosha kana ganda rakatetepa, rinotenderera rekuona, rinonzi endoscope. Kana bundu rikaonekwa, chiremba anobva aita nasopharyngeal biopsy yakaitwa, umo sampuli yetishu inotorwa uye yoongororwa pasi pemaikorosikopu.

A computed tomography (CT) scan of the dehenya base uye magnetic resonance imaging (MRI) yemusoro, nasopharynx, uye hwaro hwedehenya inoitwa kuongorora kukura kwegomarara. A positron emission tomography (PET) scan inowanzoitwawo kuongorora kukura kwegomarara nemalymph nodes mumutsipa.

Kurapa kwekutanga kunowedzera zvakanyanya kufungidzira kwekenza ye nasopharyngeal. Inenge 60-75% yevanhu vane gomarara rekutanga vane mhedzisiro yakanaka uye vanorarama kweinenge makore mashanu mushure mekuongororwa.

Sezvineiwo ese ENT cancers, nzira dzakasiyana uye nzira yekurapa inokurukurwa muCPR kuitira kupa murwere chirongwa chemunhu. Musangano uyu unoitwa pamberi pevarapi vakasiyana siyana vanobatanidzwa mukuchengeta murwere:

• chiremba anovhiya;
• radiothérapeute;
• oncologist;
• radiologist;
• psychologist;
• anatomopathologist;
• chiremba wemazino.

Nekuda kweiyo topography uye kuwedzera kwenzvimbo, kenza dzenasopharyngeal hazviwanikwe mukuvhiya kurapwa. Vanowanzo kurapwa nechemotherapy uye radiotherapy, iyo inowanzoteverwa neadjuvant chemotherapy:

• chemotherapy: inoshandiswa zvakanyanya, nekuti kenza dzenasopharyngeal ndeye chemosensitive tumors. Mishonga inoshandiswa zvakanyanya ndeye bleomycin, epirubicin uye cisplatin. Chemotherapy inoshandiswa yoga kana pamwe chete neradiotherapy (concomitant radiochemotherapy);
• ekunze beam radiation therapy: inobata bundu uye lymph node nzvimbo;
• conformational radiotherapy ine intensity modulation (RCMI): inobvumira kuvandudzwa kwebundu dosimetric kufukidzwa nekuchengetedzeka kuri nani kwezvivakwa zvine hutano uye nzvimbo dziri panjodzi. Kuwana muhupfu hwesalivary kwakakosha kana ichienzaniswa neakajairika irradiation uye hupenyu hwehupenyu hunovandudzwa munguva refu;
• brachytherapy kana kuiswa kweradioactive implant: inogona kushandiswa sekuwedzera mushure mekuvhenekera kwekunze pachiyero chakazara kana sekubata-bata kana chiitiko chidiki chepamusoro chidzoke.

Kana bundu rikadzoka, kurapwa kwemwaranzi kunodzokororwa kana, mumamiriro ezvinhu chaiwo, kuvhiyiwa kunogona kuyedzwa. Izvi zvakadaro zvakaoma nekuti zvinowanzo sanganisira kubviswa kwechikamu chenheyo yedehenya. Dzimwe nguva inoitwa kuburikidza nemhino uchishandisa endoscope.