Application of pedicle nasoseptal flap in endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma: an analysis of 39 cases.
10.3760/cma.j.cn115330-20210815-00550
- VernacularTitle:带蒂鼻中隔黏膜瓣在内镜手术治疗复发性鼻咽癌中的应用：附39例分析
- Author:
Lu YANG
1
;
De Hui WANG
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China.
- Publication Type:Journal Article
- MeSH:
Adult;
Aged;
Female;
Humans;
Male;
Middle Aged;
Nasal Surgical Procedures/methods*;
Nasopharyngeal Carcinoma/surgery*;
Nasopharyngeal Neoplasms/surgery*;
Pharyngectomy/methods*;
Surgical Flaps;
Neoplasm Recurrence, Local/surgery*;
Treatment Outcome;
Endoscopy
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2022;57(10):1212-1218
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the therapeutic effect and contributing factors of pedicle nasoseptal flap in endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma. Methods: Thirty-nine patients with recurrent nasopharyngeal carcinoma admitted to the Eye, Ear, Nose and Throat Hospital of Fudan University from July 2016 to July 2019 were reviewed, with 19 males and 20 females, aging from 30 to 75 years old. All patients underwent endoscopic nasopharyngectomy, followed by reconstruction with the pedicle nasoseptal flap. The methods of preoperative assessment, mucosal flap preparation and nasopharyngeal reconstruction were summarized, and factors affecting the survival of the pedicle nasoseptal flap were discussed. The rates between groups were compared by Fisher's exact test. Results: Ipsilateral mucosal flap was used in 19 cases while contralateral mucosal flap in 20 cases. After the operation, there were 33 cases with complete epithelialization and 6 cases with flap necrosis. Univariate analysis suggested that the number of radiotherapy courses was an important factor affecting the survival of flap (OR=7.429, 95%CI: 1.120-49.270, P=0.042). However, gender, age, type of transnasal endoscopic nasopharyngectomy, osteonecrosis, side of flap and internal carotid artery resection had no influence on flap survival (all P>0.05). All patients were followed-up for 24 to 60 months. Among them, 8 patients had local recurrence and then operated again, 4 patients survived with systemic metastases and 2 patients died. Conclusion: The pedicle nasoseptal flap is a good material for reconstruction for endoscopic nasopharyngectomy, but it is less effective for patients with multiple course radiotherapy.
