[摘要] 目的 探讨以头痛为首发症状的鼻咽癌患者的误诊原因。方法 对32例以头痛为首发症状的鼻咽癌患者的临床资料进行回顾性分析。结果 32例以头痛为首发症状的鼻咽癌患者中有23例(71.87%)合并颅神经损害，容易被误诊为神经系统疾病，而且鼻咽癌的病理类型以浸润型(15/32，46.87%)和粘膜下型(6/32,18.75%)为主，此类患者CT平扫不易发现早期病变，活检时如取材不深不易确诊。 结论 提高对头痛症状的认识，重视鼻咽部和颅底的影像学检查，以及鼻咽部多次活检可以降低鼻咽癌的误诊。

    [关键词] 头痛 ；鼻咽癌 ；诊断

    Analysis of misdiagnose for nasopharyngeal carcinoma with headache as initial appearance CAI Zhaoyang，CHEN Xiaoyou， YING Zhengbiao. Department of otorhinolaryngology, The First Hospital of Wenling. Wenling 317500, China

    [Abstract] Objective To explore the cause for misdiagnose of nasopharyngeal carcinoma (NPC) with headache as initial appearance. Methods The clinical features of 32 NPC patients with headache as initial appearance were retrospective analyzed. Results 23 of 32 NPC patients with headache as initial appearance had cranial nerves involvement and could be easily be misdiagnosed as intracranial disease .Invasive type and submucous type were the general histological type in these patients. Early disease might not be easily found by CT scan and was misdiagnosed if biopsy depth was not enough. Conclusion It was important to emphasize the role of headache as the initial appearance in NPC and the value of imaging of cranial base in the diagnosis. Repeated biopsy of nasopharynx could reduce the misdiagnosis of NPC. ......