gms | German Medical Science

GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNOKHC)

ISSN 1865-1038

Surgical Treatment of Nasal Carcinoma Spreading into Infratemporal Fossa

Poster Onkologie

  • corresponding author Debora Jančatová - ENT Department, University Hospital Ostrava, Ostrava, Czech Republic
  • Petr Matoušek - ENT Department, University Hospital Ostrava, Ostrava, Czech Republic
  • Martin Formánek - ENT Department, University Hospital Ostrava, Ostrava, Czech Republic
  • Karol Zeleník - ENT Department, University Hospital Ostrava, Ostrava, Czech Republic
  • Pavel Komínek - ENT Department, University Hospital Ostrava, Ostrava, Czech Republic

GMS Curr Posters Otorhinolaryngol Head Neck Surg 2014;10:Doc135

doi: 10.3205/cpo000897, urn:nbn:de:0183-cpo0008976

Published: May 19, 2014

© 2014 Jančatová et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Abstract

Introduction: Sinonasal malignancies represent less than 1% of all malignancies, the most frequent type (in 70–80%) is squamous cell carcinoma. The standard treatment of the sinonasal squamous cell carcinoma is complete surgical removal and postoperative radiotherapy. The surgery should be as radical as necessary, but as minimally traumatic as possible. As a result of the surgery, aesthetic and/or functional problems may arise in some extensive cases.

Methods: A squamous cell carcinoma was diagnosed in 70-year-old patient with obstruction of the left nasal cavity lasting for one month. Computed tomography showed extensive tumor of the paranasal sinuses with destruction of the hard palate and spreading into infratemporal fossa (T4N0M0). Tumor was removed using combination of external (subtotal maxillectomy) and endoscopic approach (infratemporal fossa region). As a part of the surgery, hard palate was resected and large communication between oral and nasal cavity resulting in significant swallowing a speech problems came up. Therefore, as it was planned, the reconstruction of the hard palate with the radial forearm fasciocutaneous free flap was performed one week later. Adjuvant radiotherapy started one month later.

Results: Complete removal of the tumor was possible using combined external and endoscopic approach. Hard palate was restored using free flap with perfect swallowing result.

Conclusions: Combined external and endoscopic approach with subsequent reconstruction of hard palate can be used as appropriate surgical option for large tumors of the paranasal sinuses with good functional result and preservation of quality of life.

Unterstützt durch: Institutional Support of the Ministry of Health no. 2 RVOFNOs/2013, GA MZCR NT13725-4/2012

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