{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:58:11Z","timestamp":1790974691929,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81772895"],"award-info":[{"award-number":["81772895"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81874134"],"award-info":[{"award-number":["81874134"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Salvage endoscopic nasopharyngectomy (ENPG) is a reasonable choice for resectable recurrent nasopharyngeal carcinoma (rNPC). However, in past decades, complete removal of the tumor was not feasible when the recurrent lesion was adjacent to the internal carotid artery (ICA). The present article introduces innovative strategies to ensure sufficient surgical margins while avoiding accidental injury to the ICA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed rT2\u20103 rNPC patients with tumor lesions adjacent to the ICA (&lt;5\u00a0mm) who underwent ENPG at the Sun Yat\u2010sen University Cancer Center between January 2015 and June 2020. Thirty\u2010seven patients were selected for this study. Seventeen patients underwent ENPG using direct dissection, 10 patients underwent endoscopic\u2010assisted transcervical protection of the parapharyngeal ICA combined with ENPG, and 10 patients underwent ICA embolization followed by ENPG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>With a median follow\u2010up duration of 31\u00a0months (range, 5 to 53\u00a0months), the 2\u2010year overall survival, progression\u2010free survival, locoregional recurrence\u2010free survival, and distant metastasis\u2010free survival rates of salvage ENPG for rNPC adjacent to the ICA were 88.7%, 72.0%, 72.0%, and 97.3%, respectively. The incidences of grade 1\u20102 and grade 3\u20105 postoperative complications were 16.2% and 13.5%, respectively. Two patients experienced ICA rupture during direct dissection but were out of danger after vascular embolization therapy. One patient had a positive margin. Two patients had severe nasopharyngeal wound infections with mucosal flap necrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ENPG combined with ICA pretreatment allows the feasible and effective resection of rNPC lesions adjacent to the ICA.<\/jats:p><\/jats:sec>","DOI":"10.1177\/01945998211011076","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T04:01:52Z","timestamp":1624939312000},"page":"490-497","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Endoscopic Nasopharyngectomy Combined With Internal Carotid Artery Pretreatment for Recurrent Nasopharyngeal Carcinoma"],"prefix":"10.1002","volume":"166","author":[{"given":"Zhi\u2010Qiang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Nasopharyngeal Carcinoma Sun Yat\u2010sen University Cancer Center Guangzhou P. R. China"},{"name":"Sun Yat\u2010sen University Cancer Center State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Long","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Nasopharyngeal Carcinoma Sun Yat\u2010sen University Cancer Center Guangzhou P. R. China"},{"name":"Sun Yat\u2010sen University Cancer Center State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You\u2010Ping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nasopharyngeal Carcinoma Sun Yat\u2010sen University Cancer Center Guangzhou P. R. 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Jun","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Nasopharyngeal Carcinoma Sun Yat\u2010sen University Cancer Center Guangzhou P. R. China"},{"name":"Sun Yat\u2010sen University Cancer Center State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang\u2010Kui","family":"Gu","sequence":"additional","affiliation":[{"name":"Sun Yat\u2010sen University Cancer Center State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou P. R. China"},{"name":"Department of Minimally Invasive Interventional Radiology Sun Yat\u2010sen University Cancer Center Guangzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan\u2010Feng","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Nasopharyngeal Carcinoma Sun Yat\u2010sen University Cancer Center Guangzhou P. R. China"},{"name":"Sun Yat\u2010sen University Cancer Center State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi\u2010Kun","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Nasopharyngeal Carcinoma Sun Yat\u2010sen University Cancer Center Guangzhou P. R. China"},{"name":"Sun Yat\u2010sen University Cancer Center State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Nasopharyngeal Carcinoma Sun Yat\u2010sen University Cancer Center Guangzhou P. R. China"},{"name":"Sun Yat\u2010sen University Cancer Center State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nasopharyngeal Carcinoma Sun Yat\u2010sen University Cancer Center Guangzhou P. R. 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