Nasal endoscopy assisting combined with transoral approach for resection of carcinoma of the palate invading nasal cavity and sinuses

Abstract

Objective:To explore the value of nasal endoscopy assisting combined with transoral approach in resection of the carcinoma of the palate with the nasal cavity and sinuses invaded. Methods:A retrospective analysis of 21 patients with a primary malignant tumors of the palate was performed. Preoperative nasal endoscopy and CT and MRI scan showed that the primary tumors invading the nasal cavity and sinuses in all patients or skull base with varying degrees. All patients were treated by nasal endoscopic assisting combined with transoral approach. Postoprational adjuvant radiotherapy or concurrent chemoradiotherapy was performed according to pathological types and clinical stage. Postoperative complications, all-tumor resection rate, local control rate and 5-year survival rate were analyzed statistically. Results:The combined approach was successfully performed in all patients. En bloc resection was carried out in 18 patients by this combined approach and surgical margins were free of carcinoma. The median follow-up period was 60 months. All patients had good nasal ventilation function and no epiphora in postoperation, and the overall local control rate of primary site was 85.7%, overall 5-year survival rate was 76.2%. Conclusion:Nasal endoscopy assisting combined with transoral approach is an effective method for the resection of palate malignant tumors invading the nasal cavity and sinuses. It is convenient for en bloc resection and local control of primary lesions. It is beneficial to preserve the function of nasal cavity and sinuses, which is in line with the principle of functional surgery.