Soltaniesmaeili Amir, Farhadipour Fateme, Yousufzai Shayan, Hosseini Hossein, Farjam Saeed, Yousefi Alireza
Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
Otolaryngology, Head and neck Surgery Department, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Int J Surg Case Rep. 2025 Feb;127:110935. doi: 10.1016/j.ijscr.2025.110935. Epub 2025 Jan 24.
Nasopharyngeal stenosis (NPS) is an uncommon but significant complication that arise following tonsillectomy in adults, leading to manifestations including obstructive sleep apnea and dysphagia. This condition is often rare, underscoring the need for awareness and effective management strategies.
We present a case involving a 48-year-old female who developed nasopharyngeal stenosis (NPS) 15 months after undergoing a tonsillectomy. Her medical history was unremarkable, with no identifiable predisposing factors. She experienced respiratory distress, snoring, and dysphagia due to significant nasopharyngeal obstruction caused by fibrotic adhesions. The Madame Butterfly flap technique was employed, facilitating effective reconstruction while minimizing complications typically associated with skin grafts.
The existing literature on NPS in adults is limited, particularly regarding standardized management protocols. Current treatment modalities exhibit considerable variability; however, few have undergone rigorous investigation within adult populations. The Madame Butterfly technique is particularly noteworthy for its ability to achieve both functional and aesthetic repair without the drawbacks associated with traditional grafting methods. This case underscores the necessity for comparative studies involving larger sample sizes to determine optimal management strategies for NPS.
This case exemplifies the successful implementation of the Madame Butterfly technique in managing NPS following tonsillectomy, with no recurrence observed during a six-month follow-up period. Given the rarity of NPS and the lack of established protocols, there is an urgent need for updated postoperative guidelines to mitigate this complication. Future research should prioritize the development of standardized management approaches to improve surgical outcomes for patients affected by NPS.
鼻咽狭窄（NPS）是成人扁桃体切除术后出现的一种罕见但严重的并发症，可导致包括阻塞性睡眠呼吸暂停和吞咽困难等表现。这种情况通常很罕见，这凸显了提高认识和制定有效管理策略的必要性。
我们报告一例48岁女性病例，该患者在扁桃体切除术后15个月出现鼻咽狭窄（NPS）。她的病史无异常，无明显的诱发因素。由于纤维化粘连导致严重的鼻咽阻塞，她出现了呼吸窘迫、打鼾和吞咽困难。采用了蝴蝶瓣技术，有助于有效重建，同时将通常与皮肤移植相关的并发症降至最低。
关于成人鼻咽狭窄（NPS）的现有文献有限，特别是在标准化管理方案方面。目前的治疗方式差异很大；然而，很少有在成人人群中进行严格研究的。蝴蝶瓣技术特别值得注意的是，它能够实现功能和美学修复，而没有传统移植方法的缺点。本病例强调了进行更大样本量的比较研究以确定鼻咽狭窄（NPS）最佳管理策略的必要性。
本病例例证了蝴蝶瓣技术在扁桃体切除术后管理鼻咽狭窄（NPS）方面的成功应用，在六个月的随访期内未观察到复发。鉴于鼻咽狭窄（NPS）的罕见性以及缺乏既定方案，迫切需要更新术后指南以减轻这种并发症。未来的研究应优先制定标准化管理方法，以改善受鼻咽狭窄（NPS）影响患者的手术效果。
