gms | German Medical Science

83. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

16.05. - 20.05.2012, Mainz

Endoscopic Nasopharyngectomy for Locally Recurrent Nasopharyngeal Carcinoma: Anatomy and Salvage surgery

Meeting Abstract

Suche in Medline nach

  • corresponding author Weiping Wen - The First Affiliated Hospital of Sun Yat-Sen Unive, Guangzhou, P.R.China

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 83. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Mainz, 16.-20.05.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12hnod682

doi: 10.3205/12hnod682, urn:nbn:de:0183-12hnod6825

Veröffentlicht: 4. April 2012

© 2012 Wen.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Nasopharyngectomy for recurrent nasopharyngeal carcinoma (rNPC) using an endoscopic technique is less invasive than traditional methods. Our primary purpose is to identify the important anatomic landmarks so the endoscopic surgeon can avoid injury to the internal carotid artery (ICA) and perform a nasopharyngectomy safely. The secondary purpose is to evaluate the efficacy of this novel approach.Transnasal endoscopic dissection was carried out on 3 fresh adult cadaver specimens (6 sides). Measurements were made in 50 adult skulls (100 sides), detailing the distances between orienting critical landmarks and the internal carotid canal (external aperture). Thirty-seven rNPC patients (rT1-rT3) who received endoscopic nasopharyngectomy during the period of 2004 to 2008 were reviewed retrospectively.Anatomy of the operative field (endoscopic view) is described. Orientating topical landmarks include: posterior portions of the inferior turbinate and nasal septum and the torus tubarius. The deep landmarks include: medial pterygoid plate - posterior margin at the skull base, Eustachian tube isthmus, foramen lacerum and the longus capitis. All topical and deep landmarks were identified from the endoscopic point of view and their distances to the internal carotid canal (external aperture) were measured. Among the 37 endoscopic nasopharyngectomies, 35 achieved en bloc tumor resection with negative surgical margins. The 2-year overall survival rate was 84.2%.Appropriate endoscopic nasopharyngectomy is a minimally invasive, safe, and promising surgical modality for the en bloc excision of rNPCs with encouraging short-term outcome. Surgeons can efficiently and safely deal with rNPC endoscopically using the above orienting landmarks. However, Long-term patient follow-up is ongoing.