Nasopharyngectomy for locally advanced recurrent nasopharyngeal carcinoma: Exploring the limits

Background The purpose of this study was to present the outcome of nasopharyngectomy for locally advanced recurrent nasopharyngeal carcinoma (NPC). Methods Between 2000 and 2010, patients with locally advanced recurrent NPC were recruited. Surgical outcomes were analyzed retrospectively. Results Among the 22 patients recruited, all had extended resections via the maxillary swing approach, resulting in exposure of the petrosal part of the internal carotid artery (ICA). One patient required craniofacial approach for tumor removal. The curative resection rate was 81.8%. Free flap reconstruction was performed in all cases. The mean follow-up period was 38.8 months. All patients survived. Although 1 patient developed local and systemic tumor recurrence, the rest of the patients remained disease free. There was no carotid blowout or osteoradionecrosis of the skull base. Conclusion Curative resections can be achieved for locally advanced recurrent NPC with good outcome. Microvascular free flap reconstruction is crucial to prevent carotid artery blowout and osteoradionecrosis of the skull base. (c) 2011 Wiley Periodicals, Inc. Head Neck, 2012