Multifactorial clinical analysis of factors affecting necrosis of nasal septal mucosal flap after salvage surgery for recurrent nasopharyngeal carcinoma

To investigate the associated risk factors affecting necrosis of the nasal septal mucosal flap (NSF) after salvage surgery for recurrent nasopharyngeal carcinoma (NPC). 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. 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. The second-course radiotherapy history, the recurrence T stage, the recurrence time, and the postoperative packing time are independent risk factors for necrosis of the nasal septal mucosal flap after salvage surgery for recurrent nasopharyngeal carcinoma.