1. Swollen lymph nodes in the neck: About 40% of patients present with swollen lymph nodes in the neck as the first symptom. Most of them have a lump in the neck by unintentional touch, which is a metastatic lymph node. The enlarged lymph nodes may be painless or slightly painful, and most of them are fixed and cannot be pushed.
2.Rhinorrhea and aspiration of blood: Mostly in the morning after waking up, the mouth will aspirate blood-stained secretions. With the progression of the disease, bloody snot may appear.
Tinnitus or (and) hearing loss: The tumor grows in the nasopharyngeal cavity near an organ called “eustachian tube”, which is a tube connecting the nasopharyngeal cavity and the ear and plays the role of balancing the air pressure in the ear. When the tumor compresses the eustachian tube, it causes unilateral tinnitus and stuffiness, which is easily misdiagnosed as “otitis media”.
4.Nasal congestion: It is caused by the tumor blocking the posterior nostril, initially on one side, but in severe cases, both sides are blocked.
5.Headache: caused when the tumor breaks the skull base or spreads into the skull and involves the nerves, the pain is partial to the temporal and top of the affected side, intermittent at first and the location is not fixed. With the expansion of invasion, the pain will be fixed and persistent.
6. Difficulty in opening mouth: late symptom, suggesting that the tumor infiltrates into the parapharyngeal space, and the lesion involves the internal and external pterygoid muscles.
7.Deviation of tongue extension: It is caused by the involvement of ipsilateral hypoglossal nerve, and the tongue extension is deviated to the affected side with tongue muscle atrophy.
8.Other cranial nerve symptoms: If the tumor spreads intracranially and invades V,VI,IV,III,II cranial nerves, in addition to headache, facial numbness, mandibular deviation and diplopia may occur. Posterior invasion of the posterior region of the stromal process causes damage to the posterior group of cranial nerves, resulting in tongue extension deviation, soft palate palsy, hoarseness, swallowing difficulty, etc.