Surgical Treatment of Nasopharyngeal Malignancies: Role of Endoscopic Endonasal Approaches

Pornthep Kasemsiri, Daniel M Prevedello, Bradley A Otto, Matthew Old, Leo F Ditzel Filho, Ted Teknos, Enver Ozer, Amit Agrawal, Amin B Kassam, Ricardo L Carrau

Abstract


Development of endoscopic techniques has progressed onward with the recent enrichment of anatomical knowledge and experience; as well as the development of advanced technologies. Expansion of the clinical indications for endoscopic endonasal approaches has produced a paradigm shift in the surgical management of nasopharyngeal malignancies similar to that of other areas of the ventral skull base.

Endoscopic endonasal nasopharyngectomy is a feasible and minimal access technique for the resection of select recurrent and radioresistant nasopharyngeal malignancies. It bestows the advantages of lack of external incisions or scars, decreased trauma to adjacent soft tissues and bone, reduced risk of neurological damage, and superior postoperative quality of life.

A comprehensive review of the available literature shows that endoscopic results are better than re-irradiation or surgery via conventional open approaches. We acknowledge that these results may be influenced by a bias in patient selection.  However, they suggest that, in properly selected cases, an endoscopic endonasal nasopharyngectomy affords low morbidity rates without compromising oncologic outcomes.  Nonetheless, one should be fully aware of the indications and limitations of using endoscopic endonasal approach to achieve optimal outcomes. Endoscopic endonasal approaches plays a strong role in the treatment of nasopharyngeal malignancies 


Keywords


Endoscopic endonasal approaches, Nasopharyngectomy, Malignancy, Nasopharynx

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DOI: http://dx.doi.org/10.15383/jnpc.14

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