Endoscopic management of skull base osteoradionecrosis

Objective: Osteoradionecrosis is one of the most serious complications in r adiotherapy of nasopharyngeal carcinoma We describe a new endoscopic approa ch to resolve resultant skull base osteoradionecrosis. The objective of thi s study is to evaluate the efficacy of endoscopic management of skull base osteoradionecrosis. Study Design: A prospective study of the outcome of end oscopic management for patients with skull base osteoradionecrosis. Methods : Between 1994 and 1998 six patients who had irradiation previously for nas opharyngeal carcinoma had skull base osteoradionecrosis. A sinoscopic appro ach was applied for diagnosis and sequestrectomy. This diagnosis was based on the criterion of exposed necrotic bone after removing all crust in the n asophargnx and further confirmed on pathological examination after sequestr ectomy, Effective cure was defined as intact mucosal coverage without any u lcer or exposed necrotic bone observed in the nasopharynx and the absence o f antecedent accompanying symptoms after management. Results: Six patients (100%) were symptom free. Five (83.3%) patients had effective cure. There w as no surgical morbidity or mortality. Conclusion: Endoscopic sequestrectom y is a justified approach to skull base osteoradionecrosis.