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Resurfacing of the nasopharynx after nasopharyngectomy using a free radial forearm flap

✍ Scribed by Mark L. C. Khoo; Khee-Chee Soo; Patrick J Gullane; Peter C Neligan; Soo-Wan Hong; Julian C. Y. Lee; Jin-Keat Siow

Publisher
John Wiley and Sons
Year
2001
Tongue
English
Weight
446 KB
Volume
23
Category
Article
ISSN
1043-3074

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✦ Synopsis

Abstract

Background

Nasopharyngectomy is emerging as an important treatment option for salvaging locally recurrent nasopharyngeal carcinoma (NPC). After nasopharyngectomy, resurfacing the nasopharynx and covering the internal carotid artery is important to minimize the risk of infection, osteoradionecrosis, and carotid rupture. Previous authors have advocated the use of free grafts of skin and mucosa for this purpose but have also described significant rates of partial and total graft failure.

Methods

We believe that the best and most reliable way to resurface the nasopharynx is with vascularized tissue, and our preference is for the use of a free radial forearm flap. To illustrate our approach, we present two patients who underwent nasopharyngectomy by means of a maxillary swing approach and who had resurfacing of the surgical defect with a free radial forearm flap.

Results

Both patients had complete en bloc resection of tumor followed by the insetting of a free radial forearm flap to reline the surgical defect. Both flaps remained completely viable, and both patients achieved successful resurfacing of the entire nasopharynx. The morbidity of surgery was minimal, and there were no perioperative complications. On assessment 1 year later, the free radial forearm flap continues to reline the entire neonasopharynx, and the long‐term functional recovery after surgery is excellent.

Conclusion

Resurfacing the nasopharynx after nasopharyngectomy with a free radial forearm flap aids healing and minimizes the risk of complications. The morbidity of surgery is minimal and the functional recovery is excellent.23: Β© 2001 John Wiley & Sons, Inc. Head Neck 23: 916–922, 2001.

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