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患者男,50岁。主诉右眼球活动受限,怕光流泪,失明半年。基层医院诊断“右眼角膜溃疡”,经滴眼药水及全身抗菌素治疗无效。于1987年4月18日转入我院,仍诊断为“右眼角膜溃疡”收住院。体查:右眼视为眼前手动,左眼视力1.0;右眼上睑下垂,眼球外展受限;角膜呈乳白色混浊,有溃疡,临近穿孔;前房积脓,瞳孔隐约可见;眼底窥不清。入院第3天耳鼻喉科会诊:追问病史先有右侧固定性头痛,右鼻塞,耳鸣,血丝涕4个月。无眼外伤史,无发烧。检查发现右侧颈深上方有乒乓球大小的无痛性肿块,质硬,固定。右鼻腔鼻甲大,有脓血鼻涕,用1％麻黄素棉片收缩鼻甲后,可见后鼻孔近端有粗糙不平的新生物,触之易出血。鼻咽右侧咽隐窝有同样的粗糙不平的新生物,波及右后鼻孔及鼻咽顶部。右耳鼓膜变浊,光
Male patient, 50 years old. The main complaint is limited right eye activities, fear of tears, blindness for six months. Primary hospital diagnosis of “right corneal ulcer”, by eye drops and systemic antibiotic therapy ineffective. On April 18, 1987 into our hospital, still diagnosed as “right corneal ulcer” admitted to hospital. Physical examination: the right eye as the front of the hand, left eye vision 1.0; right eye ptosis, limited eye outreach; corneal milky white with ulcers, near the perforation; anterior chamber empyema, pupil looming visible; clear. ENT 3rd day ENT consultation: history first asked the right fixed headache, right nasal obstruction, tinnitus, bloodshot tears 4 months. No history of eye injury, no fever. Check the table above the right neck depth of ping-pong ball painless mass, hard, fixed. The right nasal turbinates large, purulent blood runny nose, ephedrine 1% ephedrine contraction of the turbinates, visible after the proximal nostrils with rough new organisms, easy to touch the bleeding. Nasopharyngeal right pharyngeal crypts have the same rough new creatures, affecting the right nostril and the top of the nasopharynx. Right eardrum turbid, light