Juvenile nasopharyngeal angiofibroma with intracranial extension: Analysis of 23 Egyptian patients

The management of large juvenile nasopharyngeal angiofibromas with intracranial extension is controversial. We review our experience since 1980 with eighteen patients with juvenile nasopharyngeal angiofibroma. A diagnostic and treatment approach consisting of preoperative magnetic resonance imaging, embolization of feeding branches from the external carotid artery, and attempted complete resection was used in seven patients with intracranial disease since 1987. Serial magnetic resonance images were used for followup. Intracranial disease that was persistent or recurrent and demonstrated subsequent growth was irradiated (35 to 45 cGy). Extracranial tumor recurrences were reexcised. We advocate this approach as a safe and effective alternative to primary irradiation and its sequelae.

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Trimodal embolization of juvenile nasopharyngeal angiofibroma with intracranial extension

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2019.109805 ◽

2020 ◽

Vol 130 ◽

pp. 109805 ◽

Cited By ~ 1

Author(s):

Andrew J. Maroda ◽

Nicholas A. Beckmann ◽

Anthony M. Sheyn ◽

Lucas Elijovich ◽

L. Madison Michael ◽

...

Keyword(s):

Juvenile Nasopharyngeal Angiofibroma ◽

Intracranial Extension ◽

Nasopharyngeal Angiofibroma

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Pre-pubertal juvenile nasopharyngeal angiofibroma with intracranial extension

Worldwide Medicine ◽

10.5455/ww.43044 ◽

2019 ◽

pp. 1

Author(s):

Salem Bouomrani

Keyword(s):

Juvenile Nasopharyngeal Angiofibroma ◽

Intracranial Extension ◽

Nasopharyngeal Angiofibroma

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Juvenile nasopharyngeal angiofibroma with intracranial extension – diagnosis and treatment.

Otolaryngologia Polska ◽

10.5604/01.3001.0013.5275 ◽

2019 ◽

Vol 73 (6) ◽

Author(s):

Wiesław Gołąbek ◽

Anna Szymańska ◽

Marcin Szymański ◽

Elżbieta Czekajska-Chehab ◽

Tomasz Jargiełło

Keyword(s):

Infratemporal Fossa ◽

Juvenile Nasopharyngeal Angiofibroma ◽

Intracranial Extension ◽

Radiological Findings ◽

Superior Orbital Fissure ◽

Nasopharyngeal Angiofibroma ◽

Therapeutic Modalities ◽

Stage Ivb ◽

Extensive Involvement

Introduction This retrospective study analyzes radiological findings, therapeutic management and outcomes of patients with intracranial extension of juvenile nasopharyngeal angiofibroma (JNA). The routes of intracranial spread, incidence of intracranial disease and influence on therapeutic approach are discussed. Material and methods An evaluation on the records of 62 patients with JNA was performed and 10 patients with intracranial tumors were included in the study. All patients were males aged 10 to 19 years. Results According to Andrews' classification 8 patients presented with stage IIIb, 1 patient stage IVa and another patient stage IVb tumor. Intracranial invasion was extradural in 8 cases and intradural in 2 patient. Surgery was performed in 9 cases and the most common was combined approach: infratemporal fossa and sublabial transantral. One patient was referred for radiotherapy. Follow-up ranged from 8 to 26 years. There was extracranial recurrence in 2 (22%) of 9 operated patients. Conclusions The superior orbital fissure is the most frequent route of intracranial spread in patients with extensive involvement of the infratemporal fossa. Due to high risk of recurrence and potential serious complications advanced cases of JNA should be managed by experienced multidisciplinary team, preferably in tertiary referral centers, with an access to modern diagnostic and therapeutic modalities.

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Juvenile Nasopharyngeal Angiofibroma with Intracranial Extension

Otolaryngology ◽

10.1177/0194599811408694 ◽

2011 ◽

Vol 145 (3) ◽

pp. 498-504 ◽

Cited By ~ 12

Author(s):

Tobias Alecio Mattei ◽

Gustavo Fabiano Nogueira ◽

Ricardo Ramina

Keyword(s):

Juvenile Nasopharyngeal Angiofibroma ◽

Intracranial Extension ◽

Nasopharyngeal Angiofibroma

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Surgical Experience with Juvenile Nasopharyngeal Angiofibroma

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948909800406 ◽

1989 ◽

Vol 98 (4) ◽

pp. 269-272 ◽

Cited By ~ 16

Author(s):

Daya Maharaj ◽

Carlos M. C. Fernandes

Keyword(s):

Surgical Procedures ◽

Surgical Excision ◽

Juvenile Nasopharyngeal Angiofibroma ◽

Intracranial Extension ◽

Lateral Rhinotomy ◽

Total Excision ◽

Surgical Experience ◽

Nasopharyngeal Angiofibroma ◽

Transpalatal Approach ◽

Second Procedure

Our experience with 18 cases of juvenile nasopharyngeal angiofibroma (jna) over a period of 9 years is discussed. All cases were managed surgically: 17 via a transpalatal approach and one case by a combined transpalatal, lateral rhinotomy, and transantral approach. In this series there were two recurrences following primary surgical procedures and these required a second procedure. There were no major complications and all 18 patients are alive. We believe that surgical excision should be the treatment of choice for jna and that radiotherapy should be used adjunctively for cases wherein intracranial extension of the tumors prevents total excision.

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