Abstract
Objective
To develop a predictive model assessing risk factors for nasal septal mucosal flap (NSF) necrosis in patients with recurrent nasopharyngeal carcinoma (NPC) undergoing endoscopic tumor resection and flap repair surgery.
Methods
A retrospective analysis was conducted on patients with recurrent NPC who underwent endoscopic salvage surgery and NSF repair. Factors analyzed included second-course radiotherapy history, recurrence T stage, recurrence time, and postoperative packing time. Logistic regression identified independent risk factors, and a predictive model was developed.
Results
Second-course radiotherapy, advanced T stage recurrence, longer recurrence time, and shorter postoperative packing time were identified as independent risk factors for NSF necrosis. Patients with second-course radiotherapy had an 8.338 times higher risk of flap necrosis. Advanced T stage and longer recurrence times were also associated with increased risk. Nasal packing for less than 5 days presented a higher risk of flap necrosis compared to packing for 5 days or more. The predictive model demonstrated good predictive ability.
Conclusion
The predictive model effectively identifies high-risk situations for NSF necrosis in recurrent NPC patients undergoing salvage surgery, aiding clinicians in precise surgical planning and targeted interventions to reduce complications, improve success rates, and enhance patient quality of life.