Surgical Treatment of Nasopharyngeal Malignancies: Role of Endoscopic Endonasal Approaches

Abstract

Abstract:The development of endoscopic techniques has progressed onward with the recent enrichment of anatomical knowledge and experience, as well as the development of advanced technologies. Expansion of the clinical indications for endoscopic endonasal approaches has produced a paradigm shift in the surgical management of nasopharyngeal malignancies similar to that of other areas of the ventral skull base.Endoscopic endonasal nasopharyngectomy is a feasible minimal access technique indicated for the resection of select recurrent and radioresistant nasopharyngeal malignancies. It bestows the advantages of lack of external incisions or scars, decreased trauma to adjacent soft tissues and bone, reduced risk of neurological damage, and superior postoperative quality of life.A comprehensive review of the available literature shows that endoscopic surgery end-results are better than those yielded by re-irradiation or surgery via conventional open approaches. We acknowledge, however, that these results may be influenced by a bias in patient selection. Nonetheless, they suggest that, in properly selected cases, an endoscopic endonasal nasopharyngectomy affords low morbidity rates without compromising oncologic outcomes.Therefore, endoscopic endonasal approaches play a strong role in the treatment of nasopharyngeal malignancies.Nonetheless, one should be fully aware of the indications and limitations of using endoscopic endonasal approach to achieve optimal outcomes.