Using a nasoseptal flap for the reconstruction of osteoradionecrosis in nasopharyngeal carcinoma: A case report

Kai-Ping Chang,Mohamad Adel

doi:10.1186/s40463-016-0139-1

Abstract

BackgroundOsteoradionecrosis (ORN) is a challenging complication in patients with postirradiated nasopharyngeal carcinoma (NPC). The aim of this study was to evaluate the usage of a nasoseptal flap (NSF) after endoscopic sequestrectomy to reconstruct resultant skull base defects for the treatment of ORN.Case PresentationWe present our experience on the adaption of an NSF as a reconstruction method for bony clival defects after endoscopic sequestrectomy in patients with postirradiated NPC. We propose that by which the patient may be offered better and prompt surgical results in the more adequate coverage of a vascularized flap for the exposed defect and attenuate the hypoxic and inflammatory process among the NPC patients suffering from postirradiation ORN.ConclusionsTo our knowledge, NSF use in such an indication has not been previously reported. Consequently, we advocate its utility for the management of patients with postirradiated skull base ORN in NPC in the future.

Highlights

Osteoradionecrosis (ORN) is a challenging complication in patients with postirradiated nasopharyngeal carcinoma (NPC)
As the nasopharynx is anatomically obscure and difficult to examine in clinical practice, skull base ORN remains one of the most challenging complications of radiotherapy to diagnose and manage
Clinical diagnosis of skull base ORN is based on symptoms, imaging, and endoscopy

Summary

Introduction

Osteoradionecrosis (ORN) is a challenging complication in patients with postirradiated nasopharyngeal carcinoma (NPC). The aim of this study was to evaluate the usage of a nasoseptal flap (NSF) after endoscopic sequestrectomy to reconstruct resultant skull base defects for the treatment of ORN. Case Presentation: We present our experience on the adaption of an NSF as a reconstruction method for bony clival defects after endoscopic sequestrectomy in patients with postirradiated NPC. As the nasopharynx is anatomically obscure and difficult to examine in clinical practice, skull base ORN remains one of the most challenging complications of radiotherapy to diagnose and manage. Clinical diagnosis of skull base ORN is based on symptoms, imaging, and endoscopy. Endoscopic evaluation of skull base ORN in postirradiated NPC reveals exposed necrotic bone and a copious crust in the nasopharynx [2]

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Discussion

Conclusion