A case of endoscopic surgery for skull base osteoradionecrosis after radiotherapy for nasopharyngeal carcinoma

Abstract

Skull base osteoradionecrosis is one of the most serious post-irradiation complications. In spite of localized lesions, patients have symptoms of foul odor and headache, which are very uncomfortable. What is even worse, without appropriate management, is that a mortal complication such as a rupture of the internal carotid artery may occur. We must recognize this disease and take a positive attitude toward this problem.
We report on a 61-year-old man with skull base osteoradionecrosis after re-irradiation for a recurrence of nasopharyngeal carcinoma. Based on a few literature reviews, endoscopic sequestrectomy is very effective for relief of symptoms and prevention of the rupture of the internal carotid artery. But, if we accidentally expose the internal carotid artery during surgery, we may induce rupture of said artery. So, we must choose the method of treatment carefully. Furthermore, we should understand the structure of the skull base in detail and work cautiously during surgery.