Application of temporalis muscle flap in repair and reconstruction after the resection of tumor or necrotic foci following radiotherapy of nasopharyngeal carcinoma
Gao Kelei, Zhang Hua, Xie Zhihai, Zhang Junyi, Fan Ruohao, Wang Fengjun, Xie Shumin, Zhao Suping, Jiang Weihong
Abstract
ObjectiveTo summarize and popularize the application of temporalis muscle flap in repair and reconstruction after the resection of tumor or necrotic foci following radiotherapy of nasopharyngeal carcinoma (NPC).
MethodsA retrospective analysis was made on the patients treated in the Department of Otorhinolaryngology Head and Neck Surgery of Xiangya Hospital between January 2019 and March 2021 who underwent surgical resection of tumor or necrosis of NPC after radiotherapy and temporalis muscle flap repair. The effect of the repair and the patients′ postoperative conditions were analyzed.
ResultsA total 29 patients, 19 males and 10 females, aged from 33 to 65 years old, were included in the study, and were followed up for 6-35 months. Except for 2 patients who were not followed due to bleeding or special bacterial infection, the others′ temporalis muscle flap healed well and no cerebrospinal fluid rhinorrhea or massive hemorrhage occurred. After the operation, all patients had no nasopharyngeal reflux or new open rhinolalia, and in some patients, the open rhinolalia even got relieved. Except for one case of depressed temporal fossa caused by infection and followed debridement and another one case of shallowed forehead wrinkles, the appearances of the other patients were basically symmetrical. Some patients had temporary mouth opening limitation after operation, and all of them recovered after rehabilitation exercises.
ConclusionsThe temporalis muscle flap can protect the skull base and internal carotid artery, and improve the quality of life of patients after the resection of NPC or necrotic foci. It is a reliable pedicled flap for repairing skull base defect with simple operation procedures and relatively few complications.
Key words:
Nasopharyngeal carcinoma; Temporal muscle flap; Post-radiotherapy necrosis; Skull base reconstruction
Contributor Information
Gao Kelei
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Otorhinolaryngology Major Disease Research Key Laboratory of Hunan Province, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
Zhang Hua
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Otorhinolaryngology Major Disease Research Key Laboratory of Hunan Province, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
Xie Zhihai
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Otorhinolaryngology Major Disease Research Key Laboratory of Hunan Province, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
Zhang Junyi
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Otorhinolaryngology Major Disease Research Key Laboratory of Hunan Province, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
Fan Ruohao
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Otorhinolaryngology Major Disease Research Key Laboratory of Hunan Province, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
Wang Fengjun
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Otorhinolaryngology Major Disease Research Key Laboratory of Hunan Province, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
Xie Shumin
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Otorhinolaryngology Major Disease Research Key Laboratory of Hunan Province, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
Zhao Suping
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Otorhinolaryngology Major Disease Research Key Laboratory of Hunan Province, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
Jiang Weihong
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Otorhinolaryngology Major Disease Research Key Laboratory of Hunan Province, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China
