Analysis of curative effect and risk factors of pedicled nasal septum flap in endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma
Objective To explore the efficacy and risk factors of pedicled nasal septum flap in endoscopic nasopharyn-gectomy for recurrent nasopharyngeal carcinoma.Methods From May 2018 to May 2022,totally 84 patients with re-current nasopharyngeal carcinoma were treated with ENPG in our hospital.All patients were given pedicled nasal sep-tum flap repair and endoscopic nasopharyngectomy(ENPG),and the necrosis of pedicled nasal septum mucosal flap and its risk factors were analyzed after treatment.Results Up to October,2023,there were 13 cases of nasal septum mucosal flap necrosis,the necrosis rate was 15.48％.Among them,7 cases were cleaned up regularly,and finally the nasopharynx healed in the second stage,4 cases were repaired with free nasal mucosa flap and nasopharyngeal necrotic tissue resection,and 2 cases recurred locally and survived with tumors.Thirteen cases of nasal septum mucosal flap necrosis were included in the necrosis group,and the rest were included in the survival group.By univariate analysis,there were significant differences in T stage,N stage,radiotherapy course,hemoglobin and NK cell ratio between the necrosis group and the survival group(P＜0.05).logistic regression analysis showed that N stage(N2-N3),radio-therapy course(two courses)and hemoglobin(anemia)were the risk factors of nasal septum mucosal flap necrosis,and the proportion of NK cells ≥20％was the protective factor of nasal septum mucosal flap necrosis(P＜0.05).Conclusion The pedicled nasal septum flap is a good repair material for the treatment of recurrent nasopharyngeal carcinoma by ENPG,but the effect of patients with N stage(N2-N3),radiotherapy course(two courses),hemoglobin(anemia)and NK cell ratio＜20％is slightly worse.
RecurrenceNasopharyngeal carcinomaPedicled nasal septumEndoscopeTherapeutic effectNasopha-ryngeal resectionRepair material
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