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May 1990

Split-Palate Approach for Gold Grain Implantation in Nasopharyngeal Carcinoma

Author Affiliations

From the Department of Surgery, University of Hong Kong, Queen Mary Hospital (Drs Wei, Ho, and Lam), and the Institute of Radiotherapy and Oncology, Queen Mary Hospital (Drs Sham and Choy), Hong Kong.

Arch Otolaryngol Head Neck Surg. 1990;116(5):578-582. doi:10.1001/archotol.1990.01870050078011

• Although nasopharyngeal carcinoma is radiosensitive, local failure after external radiotherapy is not uncommon and management of persistent or recurrent disease is a therapeutic challenge. The present review reports the use of brachytherapy in the form of gold grain (198Au) implants in the treatment of 23 patients with recurrent or persistent primary nasopharyngeal carcinoma. The split-palate approach was employed in the insertion of the gold grains. This approach allows adequate exposure of the nasopharynx and accurate positioning of the implants. Implantation was successful in 21 patients, and local tumor control was achieved in 17 patients (81%) after a median follow-up of 23 months. Palatal fistula developed in 6 patients (26%): 5 healed with conservative management, and 1 had no functional disturbance. There was no operative mortality, and morbidity of the operation was minimal.

(Arch Otolaryngol Head Neck Surg. 1990;116:578-582)