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鼻咽癌是中国特别是南方常见的癌瘤,由于鼻咽与眼眶和颅神经在解剖部位上有毗邻的联系,因此鼻咽癌合并有眼部症状及体征者很常见,而且常常为主要症状就诊于眼科。本文报告中山医科大学附属肿瘤医院1964年3月至1965年8月以及1985年3月至8月共检查住院鼻咽癌病人510例合并有眼部症状81例,占15.88％。眼部症状以第Ⅵ对颅神经损害引起复视最为常见,81例中占73例(90％),而且较早出现;其次为眼痛合并头痛56例(69％),上睑下垂36例(44.4％),视力下降或失明28例(34.6％),突眼18例(22.2％),何纳氏综合征11例(13.6％)。同时合并第Ⅲ、Ⅳ、Ⅴ、Ⅵ颅神经损害符合海绵窦综合症18例 (22.2％);同时合并第Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ颅神经损害并有突眼符合眶尖综合症14例(17.3％);先有视力下降或失明的第Ⅱ对颅神经损害而后出现第Ⅲ、Ⅳ、Ⅴ、Ⅵ颅神经损害符合垂体—蝶骨综合征者2例(2.46％)。以眼部症状为主而去眼科诊治的24例(29.6％),常诊断为斜视、视网膜炎、球后肿瘤等。因此凡不明原因的眼肌麻痹、复视、失明、突眼、上睑下垂症状的患者,特别是广东籍人应该排除鼻咽癌之可能。鼻咽癌出现眼症已属晚期,预后较差。
Nasopharyngeal carcinoma is a common cancer in China, especially in South China. Because nasopharyngeal and adjacent orbital and cranial nerves have adjacent anatomical sites, nasopharyngeal carcinoma is common and frequently presents as the main symptom Visiting ophthalmology. This article reports Sun Yat-sen University Cancer Hospital from March 1964 to August 1965 August and March 1985 to check a total of 510 cases of hospitalized patients with nasopharyngeal carcinoma with eye symptoms in 81 cases, accounting for 15.88%. Ocular symptoms in the first Ⅵ of the cranial nerve damage caused by diplopia is the most common, 81 cases accounted for 73 cases (90%), and earlier appeared; followed by eye pain with headache in 56 cases (69%), ptosis in 36 cases (44.4%), visual acuity or blindness in 28 cases (34.6%), exophthalmia in 18 cases (22.2%) and Heath’s syndrome in 11 cases (13.6%). In the meantime, 18 cases (22.2%) of cranial nerve lesions complicated with cranial nerves Ⅲ, Ⅳ, Ⅴ, and Ⅵ were complicated with cranial nerve lesions Ⅱ, Ⅲ, Ⅳ, Ⅴ, Ⅵ and had orbital apex syndrome 14 Cases (17.3%); first decreased visual acuity or blindness of cranial nerve damage Ⅱ and then appeared Ⅲ, Ⅳ, Ⅴ, Ⅵ cranial nerve injury in line with pituitary-sphenoid syndrome in 2 cases (2.46%). 24 cases (29.6%) were treated with ophthalmic symptom and ophthalmology, often diagnosed as strabismus, retinitis and retrobulbar tumors. Therefore, any unexplained ophthalmoplegia, diplopia, blindness, exophthalmos, ptosis symptoms in patients, especially Cantonese should rule out the possibility of nasopharyngeal carcinoma. Ocular nasopharyngeal carcinoma is late, the prognosis is poor.