> Otolaryngology and Facial Plastic Surgery > Head & Neck SurgeryMalignant Nasopharyngeal Tumors

Author: Ho-Sheng Lin, MD, Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Faculty, Sleep Fellowship Program, Divison of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Wayne State University School of Medicine; Chief, Section of Otolaryngology, Department of Surgery, John D Dingell Veterans Affairs Medical CenterCoauthor(s): Willard E Fee, Jr, MD, Edward C and Amy H Sewall Professor, Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical CenterContributor Information and DisclosuresUpdated: Dec 21, 2007

Introduction

History of the Procedure

External beam radiation therapy is the primary mode of therapy for previously untreated nasopharyngeal carcinoma (NPC). Recurrent or persistent disease remains a challenge to clinicians. Typically, re-irradiation is advocated. In some institutions, salvage nasopharyngectomy is used for the treatment of recurrent disease. In 1988, Fee and Tu published results of salvage nasopharyngectomy in a series of patients with recurrent NPC that failed previous treatment with radiation.1,2 The results were encouraging1 and inspired other investigators to start using surgery in the treatment of patients with recurrent NPC. Since then, various surgical approaches to the nasopharynx have been proposed. These include the transpalatal-maxillary-cervical, maxillary swing, transmandibular, transcervico-mandibulo-palatal, infratemporal fossa, lateral temporal, and endoscopic approaches.

Frequency

NPC is a prevalent malignancy in Southeast Asia. In areas such as southern China, Hong Kong, Singapore, Malaysia, and Taiwan, the reported incidence rate ranges from 10-53 cases per 100,000 persons per year. The incidence is also high among Eskimos in Alaska and Greenland and in Tunisians, ranging from 15-20 cases per 100,000 persons per year. Although NPC is a relatively uncommon disease in Western countries (