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Surgical management of radiation-induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: Report of 14 cases

✍ Scribed by Yong-gao Mou; Ke Sai; Zhen-ning Wang; Xiang-heng Zhang; Yan-chun Lu; Da-nian Wei; Qun-ying Yang; Zhong-ping Chen


Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
791 KB
Volume
33
Category
Article
ISSN
1043-3074

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✦ Synopsis


Abstract

Background

Radiation‐induced temporal lobe necrosis is a rare and serious late complication in irradiated patients with nasopharyngeal carcinoma (NPC). Treatment of radiation‐induced temporal lobe necrosis with surgery has been seldom thoroughly investigated.

Methods

We retrospectively analyzed the clinical data of 14 patients with radiation‐induced temporal lobe necrosis treated with surgical intervention.

Results

Radiation‐induced temporal lobe necrosis presented as obvious cystic formation or as heterogeneous enhanced nodule on MRI. Among 3 patients with ^18^F‐fluorodeoxyglucose (^18^F‐FDG) PET‐CT scan, increased uptake of ^18^F‐FDG was observed in 2 cases. Four patients were anesthestized nasotracheally and 1 was through tracheostomy during surgery because of other radiation complications, including trismus and skull base osteoradionecrosis. The temporal approach was applied in all cases, with the removal of bone flap in 11 patients. During follow‐up, 1 patient died of exhaustion.

Conclusions

Surgery benefits selected patients with NPC with radiation‐induced temporal lobe necrosis. The goals of surgery are to relieve the increased intracranial pressure and to establish the accurate diagnosis. © 2010 Wiley Periodicals, Inc. Head Neck, 2010


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