Morbidities and quality of life after maxillary swing nasopharyngectomy for recurrent nasopharyngeal carcinoma

Abstract

BACKGROUND: The maxillary swing approach provides a good access that allows maximal resection of recurrent NPC. The aim of the current study was to report the morbidities and quality of life of patients after surgery. METHODS: A prospective study of the early and late morbidities after surgery was performed. A longitudinal investigation of the quality of life before and 1 year after surgery was performed using the self-reported, EORTC questionnaire. RESULTS: Salvage nasopharyngectomy was performed for 338 patients during 1990 to 2012. There was no hospital mortality. The morbidities were actively prevented by modifications of surgical techniques, leading to a significant reduction in the incidence of postoperative trismus (42.1 vs. 9.2%, p = 0.01) and palatal fistula formation (24.0 vs.3.7%, p = 0.01). Patients with locally advanced tumor, particularly those who required adjuvant chemoradiation, had higher chance of facial numbness, nasal blockage, and swallowing problem after surgery. There was no significant change in the mean global health system score after surgery, except those after palliative resection requiring adjuvant chemoradiation. Social functioning had the lowest scores among the five functioning scales in all groups of patients. Palatal fistula significantly affected social eating and weight loss, and osteoradionecrosis caused more pain and nasal discharge, severely affecting the social life of the patients. CONCLUSIONS: QOL of patients after salvage nasopharyngectomy.