Endoscopic sinus surgery for the treatment of chronic rhinosinusitis in patients with postirradiated nasopharyngeal carcinoma

Our purpose was to evaluate the efficacy and safety of endoscopic sinus surgery (ESS) in patients with nasopharyngeal carcinoma (NPC) after irradiation. A retrospective study of postirradiated NPC patients who received ESS for the treatment of chronic rhinosinusitis in Taichung Veterans General Hospital. Symptoms, endoscopic findings, and computed tomography were used to evaluate the efficacy of ESS in these patients, and the safety was evaluated by intraoperative findings and complications. Since 1996, 10 postirradiated NPC patients with chronic rhinosinusitis have been treated by ESS and followed up for at least 2 years. The interval between radiotherapy and ESS was from 4 months to 16 years. After surgery, 7 patients felt improved except for one patient who died of tumor recurrence and computed tomography scores changed from 6.6 to 3.7, although prolonged nasal crusting was observed in most patients by endoscopy. One patient was complicated with cerebrospinal fluid leakage and the dura defect was immediately repaired without any sequelae. This study shows that ESS is effective for the treatment of chronic rhinosinusitis in postirradiated NPC patients if they failed medical treatment.