Combined transcervical and orbitozygomatic approach for the removal of a nasopharyngeal adenocarcinoma. Issue 2 (April 2016)

• Record Type: Journal Article
• Authors: Masuda, Muneyuki; Fukushima, Junichi; Fujimura, Akiko; Uryu, Hideoki
• Is Part Of: Auris nasus larynx. Volume 43:Issue 2(2016)
• Page Start: 192
• Page End: 196
• Publication Date: 2016-04
• Subjects: Nasopharynx -- Middle skull base -- Transcervical approach -- Orbitozygomatic approach -- Hemifacial dismasking; Otolaryngology -- Periodicals; Electronic journals; 616
• DOI: 10.1016/j.anl.2015.06.006
• Languages: English
• ISSNs: 0385-8146

Abstract

Abstract: Objective: In some cases, the exposure and safeguarding of the internal carotid artery (ICA) are not easy by the maxillary swing approach that is used as a mainstay for the removal of nasopharyngeal tumors. To address this issue, we have developed a new combined transcervical and orbitozygomatic approach. Methods: A nasopharyngeal adenocarcinoma arose in a 52-year-old patient and occupied the right middle skull base extending to the ICA. We first identified and dissected the ICA from the posterolateral part of the tumor using a transcervical approach. Then, the tumor was approached and removed by an orbitozygomatic technique with hemifacial dismasking. The surgical defect was filled using a temporal muscle flap, which was divided into two parts according to the blood supply from either the anterior or the posterior deep temporal artery. Results: The postoperative course was uneventful and favorable cosmetic results were obtained. The patient has been free of carcinoma for more than 40 months after the surgery. Conclusion: Our new combined approach might be a good option for selected patients with nasopharyngeal tumors.