Nasopharyngeal Stenosis: A Rare Radiotherapy Complication

  • Sophia NitassiEmail author
  • Mehdi Kissi
  • Ilham Rkain
  • Anas Benbouzid
  • Abdelillah Oujilal
  • Leila Essakalli
Clinical Report



Acquired nasopharyngeal stenosis after radiotherapy for NPC is rare. We report a case of bilateral choanal stenosis and nasopharygeal stenosis in patient treated with chemo radiotherapy for undifferentieted nasopharnygeal carcinoma.

Case Report

A 68 years old man treated for undifferentiated nasopharyngeal carcinoma with chemo-radiotherapy 10 years before. He complained of complete nasal obstruction, rhinorrhea, anosmia, snoring and hearing loss. Clinical examination and imaging revealed bilateral choanal stenosis and nasopharyngeal stenosis. Patient underwent a transnasal endoscopic resection for scar tissue with stenting of posterior choanae. Restenosis was noted just after stent removal. Second endoscopic resection of stenosis was done, followed by application of mitomycin-C without stenting. Several months later, the patient has good airflow, a patent nasopharynx without reccurence of stenosis.


The use of topical mitomycin-C may prove useful in the treatment and prevention of subsequent restenosis and scar formation in larynx and tracheal. Mitomycin-C application has being shown useful in treating nasopharyngeal stenosis. It is safely used topically in various surgical sites without major side effect.


Nasopharyngeal stenosis is an unusual complication of radiotherapy that can be successfully treated with combine two modalities: surgical and mitomycin-C as an adjunct.


Nasopharyngeal carcinoma Stenosis Radiotherapy Mitomycin C 


Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest.


  1. 1.
    Lee SC, Tang P, Singh A, Kumar SS, Singh S (2009) Velopharyngeal stenosis, a late complication of radiotherapy. Auris Nasus Larynx 36:709–711CrossRefGoogle Scholar
  2. 2.
    Hussein J, Tan TS, Chong AW, Narayanan P, Omar R (2013) Velopharyngeal and choanal stenosis after radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx 40(40):323–326CrossRefGoogle Scholar
  3. 3.
    Ku PKM, Tong MCF, Tsang SS, Van Hasselt A (2001) Acquired posterior choanal stenosis and atresia: management of this unusual complication after radiotherapy for nasopharyngeal carcinoma. Am J Otolarngol 22:225–229CrossRefGoogle Scholar
  4. 4.
    Bonfils P, De Preobrajenski N, Florent A, Bensimon JL (2007) Sténose choanale post-radique: une complication rare de la radiothérapie des carcinomes nasopharyngés. Cancer/Radiothér 11:143–145CrossRefGoogle Scholar
  5. 5.
    Alon EE, Lipschitz N, Bedrin L, Gluck I, Talmi Y, Wolf M, Yakirevitch A (2014) Delayed sino-nasal complications of radiotherapy for nasopharyngeal carcinoma. Otolaryngol Head Neck Surg 151(2):354–358. doi: 10.1177/0194599814530858 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Singh B (1990) Bilateral choanal atresia: key to success with the transnasal approach. J Laryngol Otol 104:482–484CrossRefGoogle Scholar
  7. 7.
    Giannoni C, Sulek M, Friedman EM, Duncan NO (1998) Acquired nasopharyngeal stenosis. Arch Otolaryngol Head Neck Surg 124:163–167CrossRefGoogle Scholar
  8. 8.
    Van Den Abbeele T, Francois M, Narcy P (2002) Transnasal endoscopic treatment of choanal atresia without prolonged stenting. Arch Otolaryngol Head Neck Surg 128:936–940CrossRefGoogle Scholar
  9. 9.
    Jones LM, Guillory VL, Mair EA (2005) Total nasopharyngeal stenosis: treatment with laser excision, nasopharyngeal obturators and topical mitomycin-C. Otolaryngol Head Neck Surg 133(5):795–798CrossRefGoogle Scholar
  10. 10.
    Rosseneu S, Afzal N, Yerushalmi B, Ibarguen-Secchia E, Lewindon P, Cameron D et al (2007) Topical application of mitomycin-C in oesophageal strictures. J Pediatr Gastroenterol Nutr 44:336–341CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2015

Authors and Affiliations

  • Sophia Nitassi
    • 1
    Email author
  • Mehdi Kissi
    • 1
  • Ilham Rkain
    • 1
  • Anas Benbouzid
    • 1
  • Abdelillah Oujilal
    • 1
  • Leila Essakalli
    • 1
  1. 1.Otorhinolaryngology Department, Specialities Hospital, Medical School of RabatMohammed V UniversityRabatMorocco

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