Endoscopic Resection and Facial-submental Island Flap Reconstruction for Nasopharyngeal Radionecrosis Defects.

Background: This study evaluates the feasibility and efficacy of using the facial-submental island flap for reconstructing nasopharyngeal defects after endoscopic debridement of radionecrosis. Methods: A retrospective analysis was conducted on a series of 10 male patients with nasopharyngeal radionecrosis treated at our institution between January 2023 and December 2023. All patients underwent endoscopic debridement followed by immediate reconstruction with FSIFs. Results: Nine patients had isolated nasopharyngeal defects; 1 patient had a combined nasopharyngeal and oropharyngeal defect. The average duration of the procedure was 6.7 hours, with an estimated blood loss of 110 mL. The average dimensions of the FSIFs used were 7-8 × 4-5 cm. Crucially, all 10 flaps survived completely. During a 6- to 12-month follow-up, no major complications or tumor recurrences were observed. Functional outcomes were favorable, with all patients maintaining patent nasal airways and achieving acceptable speech intelligibility without hypernasality. Conclusions: The facial-submental island flap is a safe and effective alternative for reconstructing nasopharyngeal radionecrosis defects, offering advantages particularly for patients where microvascular free flaps are challenging. The technique demonstrated reliable flap survival and good functional results in this cohort.