[Infratemporal approach in nasopharyngeal cancer: operative technics and initial results]

When nasopharyngeal cancer recurs after radiotherapy, and when the dura is not invaded, radical excision is still possible by means of the infratemporal fossa approach (ITFA), developed by the senior author. In an effort to improve the results of radiotherapy, 13 cases of residual or persistent disease were operated on by this approach between 1977 and 1981. Of seven patients with T4 tumours, all died of persistent disease within two to three years. Six patients with T1 or T2 non-keratinizing squamous cell carcinoma are alive two to five years after surgery. Only one patient needed additional surgery for another recurrence. The approach results in a complete conductive hearing loss and permanent anaesthesia of the mandibular nerve. The procedure is safe and well tolerated. Average hospital stay is 14 days. A combination of radiotherapy and surgery is recommended for T1 and T2 carcinoma in order to improve longterm survival rates.