关键词: 鼻咽癌, 放射性骨坏死, 感染, 治疗结果, 体层摄影术, 计算机

Abstract: Objective To investigate the clinical treatment strategies of osteoradionecrosis of skull base(ORN)in the patients with nasopharyngeal carcinoma(NPC)after radiotherapy. Methods All patients(n=11)diagnosed as NPC and osteoradionecrosis of the skull base were studied retrospectively with their clinical manifestations, diagnoses, therapies and prognoses. Results In the NORN group, 2 cases died of intracranial and lung infections respectively1year after the treatment. Out of the 5 survivors, 3 was in the stationary state(one was followed up five years,1 three years and 1 one year)and the other 2 were presented with repeated infection and expansion of the osteoradionecrosis lesion(one was followed up one year, one eight months). In the TORN group, 3 patients had localized necrosis, of which one had complete epithelialization(followed up 3 years)and two had continuous seepage( followed up 1 and 3 years separately), and they were not presented with expansion of the osteoradionecrosis lesion. The last patient died of massive expistaxis due to internal carotid blowout. Three patients of the group executed responsibility vascular embolization. Conclusion For ORN, early and complete clean up of the necrotic tissue by endoscopy is an effective method. Responsibility vascular embolozation can not only avoid excessive bleeding and reduce mortality, but also reduce the operation risk and thoroughly clean the necrosis.

Key words: Nasopharyngeal carcinoma, Osteoradionecrosis, infection, Treatment outcome, Computed tomography