| Case-2
A 34 year old
female who had radiotherapy for carcinoma of the nasopharynx one
year ago,
presented with facial pain and bleeding from the nose. CT and MRI
showed a recurrent tumour in the nasopharynx on the right side extending
into the infratemporal fossa. The skull base was eroded near the
foramen ovale and the tumour was infiltrating the adjacent dura.
The horizontal part of the petrous internal carotid artery (ICA)
was surrounded by the tumour. Since the angiogram showed good cross
circulation, permanent occlusion of the ICA was done at the level
of the cavernous sinus. By using an extended transfacial subcranial
approach the posterior half of the maxilla, nasopharynx, sphenoid
sinus, contents of infratemporal fossa, ramus of mandible, greater
wing of sphenoid, middle fossa dura and petrous part of ICA were
excised. The defect was closed with rectus myocutaneous free flap
with microvascular anastamosis.
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