Surgical treatment of maxillary sinusitis in a patient with nasopharyngeal cancer after a gamma-ray and photodynamic therapy

In otorhinolaryngologist practice tumors of the nasopharynx occur quite often. Neoplasms are usually asymptomatic and manifest only when choanae obturation and pharyngeal orifice of the auditory tubes squeezing develops. Such patients mainly complain on ears congestion, hearing loss and, more rarely, nasal blockage. When the diagnosis of cancer is confirmed, a course of radiation treatment or chemoradiotherapy is conducted. There are also reports of effective photodynamic treatment. During the course of the therapy, phenomena of post-radiation epithelitis develops, affecting not only the nasopharynx and the oral cavity, but also paranasal sinuses. Most often the maxillary sinuses are affected. Post-radiation sinusitis isn’t sensitive for medical therapy, so surgical treatment is more effective. The article presents a clinical case of patient with nasopharyngeal cancer received a course of radiation and photodynamic therapy. Upon the gamma-ray therapy course (total dose 60 Gr) completed non-sensitive for medical treatment right maxillary sinusitis developed, and so endoscopic antrostomy was performed. After tumor photodynamic therapy session maxillary sinusitis on the left side developed and antrostomy was also performed. In the follow up period complete tumor regression was achieved and no signs of sinus pathology were detected.

nasopharyngeal cancer, nasopharyngeal neoplasm, maxillary sinusitis, endoscopic antrostomy, gamma-ray therapy, photodynamic therapy