Transcervico-mandibulo-palatal approach in salvage surgery of nasopharyngeal carcinoma
- VernacularTitle:颈颌腭入路-下颌骨外旋在鼻咽癌挽救性手术中的应用
- Author:
Hui CHEN
;
Min ZHAO
;
Xianming CHEN
;
Maoxin WANG
- Publication Type:Journal Article
- Keywords:
Nasopharyngeal Neoplasm;
Radiotherapy, Computer-Assisted;
Recurrence;
Surgical Procedures, Operative;
Salvage Therapy
- From:
Chinese Archives of Otolaryngology-Head and Neck Surgery
2006;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the surgical approach for recurrent or residual nasopharyngeal carcinoma after radiotherapy failure. METHODS The clinical data of 12 patients with recurrent or residualnasopharyngeal carcinoma after radiotherapy failure for salvage surgery were retrospectively analyzed. The 12 patients were underwent salvage surgery via transcervico-mandibulo-palatal approach. The residual and recurrent tumors were found in 2 and 10 patients (included 2 recurrent patients after re- radiation) after radiotherapy respectively. RESULTS The paranasopharyngeal region defects were repaired with submandibular gland flaps in 10 patients and with free inferior turbinate mucosal graft in 2 patients. All of the 12 patients were followed up for more than 2 years. Seven patients survived with no evidence of disease and one patient survived with tumor. Three patients died of local recurrence and one died of distant metastasis. The 2-year survival rate was 75 %. CONCLUSION Resection of the local recurrent nasopharyngeal carcinoma via transcervico- mandibulo-palatal approach provides wide field exposure of the central skull base. The tumors located in paranasopharyngeal region can be resected en bloc and the internal carotid artery can be identified by palpation under direct vision. The surgical defects can be repaired with submandibular gland flap. The transcervico-mandibulo-palatal approach is the suitable procedure for local recurrent nasopharyngeal carcinoma with less mortality and complications.
