Use of a posterior pedicle nasal septum and floor mucoperiosteum flap to resurface the nasopharynx after endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma

Head Neck. 2012 Oct;34(10):1383-8. doi: 10.1002/hed.21928. Epub 2011 Dec 5.

Abstract

Background: Endoscopic nasopharyngectomy is a new salvage treatment for locally recurrent nasopharyngeal carcinoma (NPC). However, how to resurface the nasopharyngeal defects in endoscopic endonasal approaches to avoid persistent postoperative headache, to the best of our knowledge, has not been reported.

Methods: From September 2009 to August 2010, we used a modified posterior pedicle nasal septum and floor mucoperiosteum flap (nasal septum and floor flap, NSFF) after endoscopic nasopharyngectomy in 12 patients with locally recurrent NPC. Most of the nasal septum and floor mucoperiosteum, except for the posterior pedicle, was harvested to cover the nasopharyngeal defects.

Results: All NSFFs successfully covered the entire nasopharyngeal defects and relined the nasopharynx with good functional recovery. The nasopharyngeal wounds recovered in 28 days (range, 14 to 56 days), and the donor-site wounds recovered in 46.5 days (range, 24-84 days). No reconstruction-related complications or disease recurrences were observed.

Conclusion: The NSFF is a safe and promising reconstructive option to resurface the nasopharyngeal defect after endoscopic nasopharyngectomy in patients with locally recurrent NPC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carcinoma
  • Cohort Studies
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Nasal Septum / surgery
  • Nasal Septum / transplantation*
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / surgery
  • Nasopharynx / surgery
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Operative Time
  • Periosteum / surgery
  • Periosteum / transplantation*
  • Plastic Surgery Procedures / methods
  • Quality of Life
  • Retrospective Studies
  • Surgical Flaps / blood supply*
  • Time Factors
  • Treatment Outcome