Choanal Stenosis: An Unusual Late Complication of Radiation Therapy for Nasopharyngeal Carcinoma

Abstract

Choanal stenosis, usually a congenital anomaly in children, recently has been recognized as a late complication of radiation therapy (RT) for nasopharyngeal carcinoma (NPC). We described the clinical history, preoperative evaluation, surgical management, and postoperative course of a case of acquired choanal stenosis after RT. The patient, a 39-year-old woman, presented with a history of NPC 16 years before presentation that had been successfully treated with RT On presentation, the patient complained of decreased nasal airflow. Bilateral choanal stenosis was confirmed per rigid nasal endoscopy. Transnasal endoscopic repair with mitomycin application was performed, and nasal stents were left in place for 6 weeks. Postoperative endoscopic examination showed patent choanae and a patent nasopharynx without stenosis. The patient continues to have good airflow 20 months postoperatively. Choanal stenosis can occur as an unusual complication of RT for NPC secondary to postradiation fibrosis. This is the first report of such a complication in the West.