The anterolateral transfacial approach for the resection of nasopharyngeal carcinoma; A case report

For the treatment of nasopharyngeal carcinomas, radiotherapy with or without adjunctive chemotherapy has been generally accepted as the first choice. However, recent advances in skull base surgery and imaging diagnosis have extended the indications for surgical intervention in the treatment of recurrent or residual carcinomas. Although there are several approaches to nasopharyngeal surgery, such as the transpalatal, transmaxillary, transpterygoid, transmandibular-transcervical and infratemporal fossa approaches, Mann et al recently developed the anterolateral transfacial approach. We operated on a 57-year-old male with recurrent nasopharyngeal carcinoma using this approach. This approach is characterized by temporary removal of the malar complex and resection of the coronoid process and pterygoid plates to achieve an excellent view of the nasopharynx and retromaxillary fossa. This approach has the cosmetic advantage of preserving facial contouring by using the malar complex as a free bone graft, as well as the functional advantage of maintaining mouth opening by rehabilitation of mandibular movement. This approach is thought to be a valuable procedure for resection of nasopharyngeal carcinomas.