Nasopharyngectomy with operating microscope: A case series.
BACKGROUND
Nasopharyngectomy for excision of nasopharyngeal tumors is challenging, as access to the nasopharynx is difficult. Recently our institution embarked on two new approaches - robotic nasopharyngectomy and open nasopharyngectomy with operating microscope (NOM) via maxillary swing approach. This article proposes that the novel approach of NOM via maxillary swing aids visualization for resection of locally invasive nasopharyngeal tumors.


METHODS
Over a thirteen-month period, eight patients required nasopharyngectomy in our single Asian institution. Four underwent robotic nasopharyngectomy and four underwent NOM via maxillary swing approach. The latter four were retrospectively reviewed, and their clinical characteristics and surgical outcomes reported. Tips and pearls for operative setup and patient selection were also discussed.


RESULTS
All four patients who underwent NOM had negative intraoperative frozen sections with subsequent negative paraffin sections. All patients remained disease free post-salvage surgery.


CONCLUSIONS
NOM via maxillary swing allows better visualization and aids in augmentation of open nasopharyngectomy. This enables achievement of adequate resection margins and fewer surgical complications in locally invasive nasopharyngeal tumors.
National Cancer Centre Singapore, Singapore, 11 Hospital Drive, Singapore.
Jia Hui
JH
Jang
National Cancer Centre Singapore, Singapore, 11 Hospital Drive, Singapore.
Hiang Khoon
HK
Tan
National Cancer Centre Singapore, Singapore, 11 Hospital Drive, Singapore.
N Gopalakrishna
NG
Iyer
National Cancer Centre Singapore, Singapore, 11 Hospital Drive, Singapore.
Khee Chee
KC
Soo
National Cancer Centre Singapore, Singapore, 11 Hospital Drive, Singapore. Electronic address: tan.ngian.chye@nccs.com.sg.
Ngian Chye
NC
Tan
D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012846:Singapore; D013997:Time Factors; D016896:Treatment Outcome