Cancer of the nasopharynx: Functional surgical salvage

The primary treatment modality for nasopharyngeal carcinoma is radiotherapy (RT). When tumor persists or recurs at the nasopharynx or in the neck after irradiation, then further courses of radiotherapy are associated with recognized morbidities. The swallowing, speech abilities as well as the cervical musculoskeletal functions of the patient may be significantly affected. Surgical salvage of neck disease with radical neck dissection contributes to better tumor control with acceptable morbidity. For localized tumor in the nasopharynx, adequate extirpation of the disease together with the removal of paranasopharyngeal tissue is possible with the anterolateral approach. The operation is not difficult and the associated morbidity is minimal. After a median follow up of 3 years, the 82 patients who underwent this operation demonstrate that with adequate exposure and surgical salvage, satisfactory tumor control rate with good functional outcome is possible.