Abstract: Objective The aim of this study was to investigate the influence of relevant nutritional indicators on the success of trauma repair in patients with nasopharyngeal carcinoma with osteoradionecrosis of the skull base, and to provide clinical guidance. Methods We retrospectively analyzed 100 clinically documented complete cases who underwent endoscopic removal of necrotic tissue from the skull base and tissue trauma repair for skull base osteoradionecrosis. The effects of nutritional indicators on surgical wound repair were analyzed using univariate and multivariate Logistic regression. Also chi-square tests were used to analyze the relationship between repair success and postoperative internal carotid artery hemorrhage, and continuity-corrected chi-square tests were used to deal with the theoretical frequency 1≤T < 5 cases. Results Univariate analysis showed that the success rate of surgical repair in normal-weight ［body mass index(BMI)=(18.5-23.9)kg/m²］ patients was 6.43 times higher(OR=6.43, P<0.001)than that in low-body-weight(BMI<18.5 kg/m²)patients, whereas the success rate in obese patients(BMI≥24 kg/m²)was weight patient by 27 times(OR=27.00, P=0.003). In addition, total protein(OR=1.10, P=0.035), albumin(OR=1.29, P=0.001), total cholesterol(OR=1.69, P=0.019), and hemoglobin(OR=1.04, P=0.005)were significantly associated with successful surgical repair. Although peripheral blood lymphocyte count was associated with successful surgical repair(OR=2.32, P=0.068), the difference did not reach statistical significance. Surgical repair success was significantly lower in patients with a Controlling Nutrition Status(CONUT)score of ≥2(OR=0.20, P=0.042). After multivariate analysis further corrected for confounders, surgical repair success rates remained significantly higher in normal-weight and obese weight than in low-weight patients(OR=9.99 and 77.14, respectively; both P<0.001). However, the independent effects of other nutritional indicators were diminished in the multivariate analysis. In addition, the rate of internal carotid artery bleeding after three months was significantly lower in the successful repair group than in the failed repair group(4.62% vs. 28.57%, P=0.002). Conclusion The findings of this study suggest that BMI is a important factor that influencing the success of surgical wound repair, with normal weigh and obese patients having significantly higher surgical repair success rates than low weight patients. In addition, nutritional indices such as total protein, albumin, total cholesterol, and hemoglobin were also significantly associated with surgical repair success, whereas higher CONUT scores were associated with lower success rate. However the independent effect of BMI remained significant in the multivariate analysis, while the independent effects of the remaining nutritional metrics were attenuated. The rate of internal carotid artery bleeding after three months was significantly lower in the successful repair group than in the failed repair group, suggesting that successful surgical repair may reduce the risk of postoperative complications.

Key words: Nasopharyngeal carcinoma, Skull base osteoradionecrosis, Nutrition, Endoscopic surgery, Internal carotid artery