Tumors of the nasopharynx. It is predominantly hypofractionated carcinoma, and radiation therapy is preferred for treatment. However, there are cases of recurrence after radiotherapy, and further radiotherapy, the effect is not good, and the associated complications increase and aggravate exponentially. Therefore, it is recommended to perform salvage surgery at this time. At present, we mostly use salvage surgery via nasal endoscopy. (I have reported endoscopic salvage surgery techniques for nasopharyngeal carcinoma on many occasions in important national conferences and meetings held by national key disciplines.) Under the guidance of the navigation system, it is possible to achieve complete resection of tumors T3 and below on the basis of avoiding important vascular nerves in the skull base region. In this case, a 64-year-old female was diagnosed with “adenoid cystic carcinoma” of the nasopharynx one year ago, and tumors remained after radiotherapy was used. Radiotherapy caused some damage to her health, hair loss, anemia and related complications in the head, neck and oral cavity. Moreover, re-radiotherapy in cases where the first radiotherapy was not sensitive was less effective. After prudent evaluation, we used tumor resection in the nasopharynx and ruptured foramen area (adjacent to the internal carotid artery) via the natural nostril. The surgery was performed under the guidance of navigation through the pterygoid fossa and infratemporal fossa approach. The lateral border of the tumor was freed, the biparietal sinus floor was resected, and the superior border of the tumor was freed; the lateral posterior border of the tumor was freed from the skull base after circumventing the internal carotid artery in the area of the rupture foramen under the guidance of navigation; the back of the tumor was freed from the anterior wall of the slope and in front of the anterior fascia. The nasopharyngeal tumor was completely removed. Postoperatively, the tumor was seen to be tough and severely fibrotic. This tumor is not sensitive to radiotherapy or chemotherapy and surgery is most effective. Figure 1, the tumor is located in the nasopharynx with surface ulceration. Figure 2, preoperative MRI showed that the tumor was mainly located on the right side of the nasopharyngeal apex and invaded to the left side of the lateral wall of the left pharynx; Figure 3, the tumor was located on the top of the nasopharynx; Figure 4, PETCT showed that the tumor in the nasopharynx had increased metabolism, but the signal was moderate due to radiotherapy; Figure 5, at the end of the surgery, a clean surgical field with no residue was seen; Figure 6; the surgically removed specimens were the right pharyngeal bulbar round pillow, the right tumor and the left tumor. The difficulty of this procedure was to avoid damage to the ruptured foraminal segment of the internal carotid artery. There was minimal bleeding during the operation, and after the operation, the patient recovered rapidly and was discharged 1 week later because it was a minimally invasive procedure rather than one using a facial incision.