ABSTRACT
Most patients present with local symptoms, but involvement of cranial nerves can be the first symptom. Local symptoms depend on the tumor site. Paranasal sinus and nasal tumors cause nasal obstruction and epistaxis, as can nasopharyngeal carcinomas. If the tumor invades the orbit, proptosis can be an early symptom, usually associated with diplopia but not visual loss. These tumors affect the anterior base of the skull and, in addition to headache, can cause other neurologic symptoms such as anosmia, visual disturbances from compression of the optic nerves or diplopia from compression of ocular motor nerves in or near the cavernous sinus. Facial pain and sensory disturbance may also occur. Hearing loss with nasopharyngeal carcinoma is usually unilateral and can be conductive, due to occlusion of the eustachian tubes by the tumor.
