Curative surgery for recurrent nasopharyngeal carcinoma via the infratemporal fossa approach.
OBJECTIVE
To determine the proper indications (and thus define good candidates) for the infratemporal fossa approach (ITFA) in the treatment of recurrent nasopharyngeal carcinoma (NPC).


METHODS
Retrospective analysis of 11 consecutive patients who had recurrent NPC after radiation therapy failure and were treated with curative surgery via the ITFA approach from July 1, 1993, to November 20, 1999. The mean follow-up was 32.5 months (range, 9-56 months).


METHODS
Academic tertiary referral center.


RESULTS
Patients who had a recurrent tumor confined to the Rosenmüller fossa (rT1; n = 3) or extending to the parapharynx (rT2; n = 3) maintained a clear surgical margin and were disease free. However, patients who had rT1 (n = 1) or rT2 (n = 1) tumors crossing the midline of the posterior nasopharyngeal wall had surgical margin involvement and their tumors recurred, and all patients with rT3 (n = 2) or rT4 (n = 1) tumors eventually died of the disease.


CONCLUSIONS
Resection of recurrent NPC via ITFA is useful for tumors located in the Rosenmüller fossa with or without parapharyngeal extension. However, tumors extending to the contralateral nasopharyngeal mucosa and tumors at an advanced stage are not suitable indications for ITFA.
Choi
Jae Young
JY
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
Lee
Won Sang
WS
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001707:Biopsy, Needle; D002277:Carcinoma / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005626:Frontal Sinus; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology* / Q000628:therapy; D009305:Nasopharynx / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D013701:Temporal Bone; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome