Tang Y, Wang J M, Huang C H
Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1993 Mar;16(1):59-65.
Syncope is an uncommon symptom in patients with nasopharyngeal carcinoma (NPC). Here we report three cases of NPC with syncope. One had bilateral neck masses, invasion of the skull base, and lower cranial nerve palsies. The other two presented with neck mass only. Repeated episodes of syncope were initially controlled by intravenous atropine followed by radiotherapy and/or chemotherapy. The large primary tumor with parapharyngeal space extension and neck lymph node involvement, the invasion of the skull base and the presence of lower cranial nerve palsies are the three important risk factors for developing syncope. This is probably mainly due to the mass compression of the carotid sinus or the glossopharyngeal nerve invasion. We therefore classified these 3 cases into carotid sinus syncope type, glossopharyngeal neuralgia type and parapharyngeal space lesions type. The prognosis is poor for cases of NPC with syncope because most patients have advanced or recurrent disease, however, atropine and radiotherapy with or without chemotherapy are effective for the symptomatic treatment of syncope from locally advanced NPC.
晕厥在鼻咽癌（NPC）患者中是一种不常见的症状。在此，我们报告3例伴有晕厥的鼻咽癌病例。1例有双侧颈部肿块、颅底侵犯及下颅神经麻痹。另外2例仅表现为颈部肿块。晕厥的反复发作最初通过静脉注射阿托品控制，随后进行放疗和/或化疗。原发肿瘤巨大并向咽旁间隙扩展、颈部淋巴结受累、颅底侵犯以及存在下颅神经麻痹是发生晕厥的三个重要危险因素。这可能主要是由于肿块压迫颈动脉窦或舌咽神经受侵犯所致。因此，我们将这3例病例分为颈动脉窦晕厥型、舌咽神经痛型和咽旁间隙病变型。伴有晕厥的鼻咽癌病例预后较差，因为大多数患者患有晚期或复发性疾病，然而，阿托品以及联合或不联合化疗的放疗对局部晚期鼻咽癌所致晕厥的对症治疗是有效的。
