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Surgical management of nasal stenosis following chemoradiation for nasopharyngeal carcinoma

Published online by Cambridge University Press:  15 February 2017

V V Wilmot*
Affiliation:
ENT Department, St John's Hospital, Livingston, Edinburgh, Scotland, UK
I Hathorn
Affiliation:
ENT Department, University of Edinburgh, Scotland, UK
*
Address for correspondence: Miss Victoria V Wilmot, St John's Hospital, Livingston, ENT Department, Lauriston Buildings, Lauriston Place, Edinburgh EH3 9HA, Scotland, UK E-mail: vvwilmot@doctors.org.uk

Abstract

Background:

Nasal stenosis is a rare but significant complication of chemoradiation treatment for nasopharyngeal carcinoma. It can cause distressing obstructive symptoms for the patient and potentially interfere with monitoring for recurrence. Quality-of-life indicators are known to be very poor in this group of patients; however, there is very little evidence in the literature as to management of this complication.

Methods:

This paper presents an endoscopic day-case surgical procedure to address total posterior nasal stenosis, as conducted in three patients, which involves division of adhesions and removal of the posterior septum and posterior inferior turbinates, without the need for packing or stenting.

Results:

In this series, there was resolution of obstructive symptoms and no recurrence of stenosis during follow up (up to 20 months).

Conclusion:

This endoscopic procedure performed to manage total nasal stenosis differs from those previously described in the literature, as post-operative stenting or packing is not required, and removal of the posterior aspect of the septum is performed routinely.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented at the ENT Scotland Winter Meeting, 20 November 2015, Stirling, Scotland, UK.

References

1 British Association of Otolaryngology, Head and Neck Surgery. Head and Neck Cancer: Multidisciplinary Management Guidelines, 4th edn. London: ENT-UK, 2011 Google Scholar
2 Liu, X, Huang, X, Sun, W, Zeng, L, Han, P. Endoscopic surgery for acquired choanal atresia after radiotherapy for nasopharyngeal carcinoma. Am J Rhinol 2011;25:188–92Google Scholar
3 Alon, EE, Lipschitz, N, Bedrin, L, Gluck, I, Talmi, Y, Wolf, M et al. Delayed sino-nasal complications of radiotherapy for nasopharyngeal carcinoma. Otolaryngol Head Neck Surg 2014;151:354–8Google Scholar
4 Ku, PK, Tong, MC, Tsang, SS, Van Hasselt, A. Acquired posterior choanal stenosis and atresia: management of this unusual complication after radiotherapy for nasopharyngeal carcinoma. Am J Otolaryngol 2001;22:225–9CrossRefGoogle ScholarPubMed
5 Shepard, PM, Houser, SM. Choanal stenosis: an unusual late complication of radiation therapy for nasopharyngeal carcinoma. Am J Rhinol 2005;19:105–8Google Scholar
6 Bonfils, P, Preobrajenski, N, Florent, A, Bensimon, JL. Choanal stenosis: a rare complication of radiotherapy for nasopharyngeal carcinoma. Cancer Radiother 2007;11:143–5CrossRefGoogle ScholarPubMed