Nassif Samih J, Michel Elishama Garvens, Scott Andrew R, Tracy Lauren, Tracy Jeremiah C
Otolaryngology-Head and Neck Surgery, AdventHealth Celebration, 410 Celebration Place, Celebration, FL, 34747, United States of America.
Tufts University School of Medicine, Boston, MA, United States of America.
Am J Otolaryngol. 2023 May-Jun;44(3):103819. doi: 10.1016/j.amjoto.2023.103819. Epub 2023 Mar 1.
Nasopharyngeal stenosis (NPS) is a rare and morbid complication following radiation therapy for nasopharyngeal carcinoma. This review provides an update on management and prognosis.
A comprehensive PubMed review using the terms "nasopharyngeal stenosis," "choanal stenosis," and "acquired choanal stenosis" was performed.
Fourteen studies identified 59 patients who developed NPS after radiotherapy for NPC. 51 patients underwent endoscopic nasopharyngeal stenosis excision by cold technique (80-100% success). The remaining 8 underwent carbon dioxide (CO) laser excision with balloon dilation (40-60% success). Adjuvant therapies included postoperative topical nasal steroids in 35 patients. The need for revision was 62% in the balloon dilation group, vs 17% in the excision group (p-value <0.01).
When NPS occurs after radiation, primary excision of scarring is the most effective method of management with less need for revision surgery relative to balloon dilation.
鼻咽狭窄（NPS）是鼻咽癌放射治疗后一种罕见且严重的并发症。本综述提供了关于其治疗和预后的最新情况。
使用“鼻咽狭窄”“后鼻孔狭窄”和“获得性后鼻孔狭窄”等术语对PubMed进行了全面检索。
十四项研究共纳入59例鼻咽癌放疗后发生鼻咽狭窄的患者。51例患者接受了内镜下冷技术鼻咽狭窄切除术（成功率80 - 100%）。其余8例接受了二氧化碳（CO）激光切除联合球囊扩张术（成功率40 - 60%）。辅助治疗包括35例患者术后局部使用鼻用类固醇。球囊扩张组的再次手术需求率为62%，而切除组为17%（p值<0.01）。
放疗后发生鼻咽狭窄时，相对于球囊扩张术，瘢痕组织的初次切除是最有效的治疗方法，再次手术需求较少。
