Delayed Sinonasal Complications of Radiotherapy for Nasopharyngeal Carcinoma

Abstract

Objectives: There are only sporadic reports of delayed sinonasal complications associated with nasopharyngeal carcinoma (NPC) treated with radiotherapy. These include choanal stenosis, osteoradionecrosis, chronic sinusitis, and intranasal synechiae. The aim of this study was to identify the time of onset and incidence of complications associated with the treatment of NPC and to compare them to the extent of the primary tumor and radiation dose. Methods: A retrospective chart review was performed on all patients who presented to our institution between 1988 through 2009 and who were diagnosed and treated for NPC. The inclusion criteria required at least a 3-year follow-up. Excluded were patients with disease recurrence. Furthermore, patients were contacted prospectively and were asked to complete a SNOT-16 questionnaire. Results: Sixty-four patients were included in our review. There were 43 males and 21 females. The average age at onset was 42. The T staging for T1, T2, T3, and T4 were 22, 11, 18, and 11 respectively. There were no T staging data for one patient. Two patients suffered from synechiae, which required synechiolysis. Five patients developed osteoradionecrosis and underwent debridement. Ten patients developed choanal stenosis, and it was repaired in 2. Ten patients suffered from sinusitis. Four of those required functional endoscopic sinus surgery. Conclusions: The incidence of delayed sinonasal complications of NPC radiotherapy is not negligible, and they should be kept in mind both for the informed consent of the patients and their active detection and treatment.