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Stenting the nasopharyngeal isthmus by nasopharyngeal airway after correction of acquired total nasopharyngeal obstruction: surgical procedure and results

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Abstract

The objective of this study is to describe a simple surgical procedure for management of acquired total nasopharyngeal obstruction in adults. Five patients were diagnosed as having complete nasopharyngeal obstruction over a 3-year period. Three patients previously underwent uvulopalatoplasty, while for the remaining two it was due to pharyngoscleroma. In all the patients, nasopharyngeal obstruction was at the level of the inferior edge of the soft palate. Two of the post-uvulopalatoplasty patients had recurrent obstruction after scar excision and topical application of mitomycin-C without stenting. All the patients were treated surgically by creation of a new anatomical nasopharyngeal isthmus and stenting it by nasopharyngeal airway for 6 months. All the patients experienced satisfactory results and good tolerability to airway placement. The nasopharyngeal airway can counteract the inevitable scar contraction of the new nasopharyngeal isthmus after surgical correction and maintain its patency.

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References

  1. Cotton RT (1985) Nasopharyngeal stenosis. Arch Otolaryngol 111:146–148

    Article  PubMed  CAS  Google Scholar 

  2. Smith ME (2005) Prevention and treatment of nasopharyngeal stenosis: operative techniques. Otolaryngol Head Neck Surg 16(4):242–247

    Article  Google Scholar 

  3. Bonfils P, de Preobrajenski N, Florent A et al (2007) Choanal stenosis: a rare complication of radiotherapy for nasopharyngeal carcinoma. Cancer Radiother 11(3):143–145

    Article  PubMed  CAS  Google Scholar 

  4. Shepard PM, Houser SM (2005) Choanal stenosis: an unusual complication of radiation therapy for nasopharyngeal carcinoma. Am J Rhinol 19(1):105–108

    PubMed  Google Scholar 

  5. McLaughlin KE, Jacobs IN, Todd NW et al (1997) Management of nasopharyngeal and oropharyngeal stenosis in children. Laryngoscope 107:1322–1331

    Article  PubMed  CAS  Google Scholar 

  6. 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):795–798

    Article  PubMed  Google Scholar 

  7. Haller JR, Gray SD (1999) Severe pharyngeal stenosis treated with inferiorly based sternocleidomastoid myocutaneous flap. Ann Otol Rhinol Laryngol 108:731–734

    PubMed  CAS  Google Scholar 

  8. Stepnick DW (1993) Management of total nasopharyngeal stenosis following UPPP. Ear Nose Throat J 72(1):86–90

    PubMed  CAS  Google Scholar 

  9. Giannoni C, Sulek M, Friedman EM et al (1998) Acquired nasopharyngeal stenosis: a warning and review. Arch Otolaryngol Head Neck Surg 124(2):163–167

    PubMed  CAS  Google Scholar 

  10. Krespi YP, Kacker A (2000) Management of nasopharyngeal stenosis after uvulopalatoplasty. Otolaryngol Head Neck Surg 123(6):692–695

    Article  PubMed  CAS  Google Scholar 

  11. Lee SC, Tang IP, Singh A et al (2009) Velopharyngeal stenosis, a late complication of radiotherapy. Auris Nasus Larynx 36:709–711

    Article  PubMed  Google Scholar 

  12. Ku PK, Tong MC, Tsang SS et al (2001) Acquired posterior choanal stenosis and atresia: management of this unusual complication after radiotherapy for nasopharyngeal carcinoma. Am J Otolaryngol 22(4):225–229

    Article  PubMed  CAS  Google Scholar 

  13. Ku PK, Tong MC, van Hasselt A (2007) Application of holmium yttrium aluminium garnet (YAG) laser in treatment of acquired posterior choanal atresia following radiotherapy for nasopharyngeal carcinoma. J Laryngol Otol 121(2):138–142

    Article  PubMed  Google Scholar 

  14. Brown OE, Powell P, Manning SC (1996) Choanal atresia: a new anatomic classification and clinical management applications. Laryngoscope 106:97–101

    Article  PubMed  CAS  Google Scholar 

  15. Madgy DN, Belenky W, Dunkley B et al (2005) A simple surgical technique using the plasma hook for correcting acquired nasopharyngeal stenosis. Laryngoscope 115(2):370–372

    Article  PubMed  Google Scholar 

  16. Eppley BL, Sadove AM, Hennon D et al (2006) Treatment of nasopharyngeal stenosis by prosthetic hollow stents: clinical experience in eight patients. Cleft Palate Craniofac J 43(3):374–378

    PubMed  Google Scholar 

  17. Toh E, Pearl AW, Genden EM et al (2000) Bivalved palatal transposition flaps for the correction of acquired nasopharyngeal stenosis. Am J Rhinol 14(3):199–204

    Article  PubMed  CAS  Google Scholar 

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  1. Otorhinolaryngology Department, Mansoura University, Mansoura, Egypt

    Mohamed Abu-Samra & Hesham Eladl

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  1. Mohamed Abu-Samra
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  2. Hesham Eladl
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Correspondence to Mohamed Abu-Samra.

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Abu-Samra, M., Eladl, H. Stenting the nasopharyngeal isthmus by nasopharyngeal airway after correction of acquired total nasopharyngeal obstruction: surgical procedure and results. Eur Arch Otorhinolaryngol 269, 1993–1997 (2012). https://doi.org/10.1007/s00405-012-1970-2

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  • DOI: https://doi.org/10.1007/s00405-012-1970-2

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