Nasal and paranasal sinus changes after radiotherapy for nasopharyngeal carcinoma

Objective-To study sinonasal side-effects after radiotherapy (RT) in nasopharyngeal carcinoma (NPC) patients. Material and Methods-The study subjects comprised 32 cases of NPC (23 new cases, 9 old cases) who had been treated with RT with no recurrence. They were subjected to a saccharine test, nasal endoscopy and CT. Results-There was a gradual and persistent increase in the saccharine delay time after RT. Endoscopy showed that, early post-RT, edema and discharge were replaced by delayed crusting and adhesions. CT showed that the maxillary sinus, anterior ethmoid sinus and ostiomeatal complex were the areas most affected. Conclusions-Rhinosinusitis is a common post-RT side-effect in NPC patients, A pre-RT saccharine test is a good predictor of those patients who are more likely to develop sinonasal side-effects. Functional endoscopic sinus surgery should be considered with caution in post-RT rhinosinusitis.