Eradication dis w/ medication/ surgery
Optimal functional outcome after Tx
Direct vision - minimise surgical trauma/ complication
Surgical resection then reconstruction when appropriate (fill up hole from surgery with same tissue)
Improved visualization of the pathology
- Intranasal surgery - direct vision through endoscope
- CT-guided navigation - accurate resection
- Maxillary swing approach to central skull base (osteotomy - maxilla drops down attached to cheek flap) - resection of tumours (incl recurrent NPC after radiotherapy)
- Recurrent NPC
- Futher radio: damages surrounding tissue
- Brachytherapy: small tumours
- Chemo
- Surgery
- Combined cranial facial resection - expose anterior skull base - adequate tumour eradication.
Functional restoration
- Cochlear implantation for profound deafness (electrode into cochlear, receiver on outside)
- Voice prosthesis - total laryngectomy
- Free cutaneous flaps used after resection of intraoral tumour - improved tongue mobility of the tongue (function)
- Free osteocutaneous flaps for reconstruction of mandibular defects after resection (swallowing/ speech)
Extensive resection for eradication of disease
- Radical resection of laryngopharynx - tumour eradication (pharyngeal defect reconstructed with myocutaneous flaps or free jejunal grafts)
- Resection of whole oeso + laryngopharynx (tumour eradication) - stomach to neck for reconstruction