Reconstructive Flaps After Salvage Nasopharyngectomy

Punam G. Thakkar*, Allison Grossman, Alice Lin and Krishnamurthi Sundaram

Reconstructive Flaps After Salvage Nasopharyngectomy.

The emergence of new technologies for early diagnosis of recurrent nasopharyngeal cancer and new techniques of endoscopic nasopharyngectomy increase the incidence of
salvage nasopharyngectomy and pose the question of the ideal flap for reconstruction of this
defect.

A review of the literature to identify the flaps used in nasopharyngeal reconstruction and their advantages and disadvantages, characteristics, and outcomes. We reviewed the literature available in the English language to identify the various flaps used, their indications and surgical technique, complications and outcomes.

Multiple flaps have been used. Local mucosal flaps such as the posterior pedicled
middle turbinate mucoperiosteal flap, the posterior pedicled Nasal Septal Flap and Floor
mucoperiosteum flap, pedicled flaps such as the extended glabellar fascial cutaneous flap,
the Haddad-Bassagasteguy flap, the temporoparietal fascial flap and the pericranial flap and
free flaps such as the radial forearm and vastus lateralis flap have been described.

No single flap is ideal for all cases. A working knowledge of available flaps is essential to provide
coverage of the skull base to avoid vascular and infectious complications.

Nasopharyngeal cancer differs from other head and neck tumors in that it occurs predominantly in a younger age group and is unrelated to tobacco or alcohol exposure. It is a radiosensitive tumor and the primary treatment is radiotherapy or chemoradiotherapy.

Otolaryngol Open J. 2016; 2(1): 24-27. doi: 10.17140/OTLOJ-2-107

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