title: Delayed Sino-nasal Complications of Radiotherapy for Nasopharyngeal Carcinoma.
abstract: There are only sporadic reports of delayed sino-nasal complications associated with nasopharyngeal carcinoma (NPC) treated with radiotherapy. These include choanal stenosis, osteoradionecrosis, chronic sinusitis, and intranasal synechiae. Most likely, these complications are underestimated as in many institutions nasal endoscopies in NPC patients are not performed routinely. The aim of this study was to identify the onset and incidence of delayed sino-nasal complications in NPC patients and their effect on quality of life (QOL).
  
  
  
  Case series with chart review.
  
  
  
  Tertiary medical center.
  
  
  
  A retrospective chart review was performed on all patients treated for NPC in our institution between 1988 through 2009. The inclusion criteria required at least a 3-year follow-up without recurrence. Included patients were contacted prospectively and asked to fill a SNOT-16 questionnaire.
  
  
  
  Sixty-two patients were included in our review. There were 42 males and 20 females. The average age at onset was 42 years. The AJCC staging for T1, T2, T3, and T4 tumors was 22 (35%), 11 (18%), 18 (29%), and 11 (18%), respectively. Eleven patients (18%) suffered from chronic sinusitis. Nine patients (15%) developed choanal stenosis. Five patients (8%) developed osteoradionecrosis. Two patients suffered from nasal synechiae. Forty-eight patients completed the SNOT-16 questionnaire. Patients with choanal stenosis had the lowest QOL scores out of the cohort.
  
  
  
  The incidence of delayed sino-nasal complications after radiation treatment for NPC is not negligible and should be kept in mind when addressing the quality of life of NPC survivors.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel eranealon@yahoo.com.
authors.forename: Eran E
authors.initials: EE
authors.lastname: Alon
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel.
authors.forename: Noga
authors.initials: N
authors.lastname: Lipschitz
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel.
authors.forename: Lev
authors.initials: L
authors.lastname: Bedrin
authors.affiliation: Department of Oncology, the Chaim Sheba Medical Center, Tel Hashomer and the Tel Aviv University, Israel.
authors.forename: Iris
authors.initials: I
authors.lastname: Gluck
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Talmi
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Wolf
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, the Chaim Sheba Medical Central, Tel Hashomer and the Tel Aviv University, Israel.
authors.forename: Arkadi
authors.initials: A
authors.lastname: Yakirevitch
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000473:pathology / Q000532:radiotherapy*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010025:Osteoradionecrosis / Q000209:etiology; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D012852:Sinusitis / Q000209:etiology; D011795:Surveys and Questionnaires
keywords: NPC; choanal stenosis; chronic sinusitis; nasopharyngeal carcinoma; osteoradionecrosis; quality of life; radiotherapy; synechiae