scholarly journals Recurrent and residual juvenile angiofibromas

2007 ◽  
Vol 121 (5) ◽  
pp. 460-467 ◽  
Author(s):  
I Tyagi ◽  
R Syal ◽  
A Goyal
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Internal Carotid ◽  
Complete Removal ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Residual Tumour ◽  
Nasopharyngeal Angiofibroma ◽  
Cavernous Sinus Invasion ◽  
Pterygoid Canal ◽  
Infratemporal Approach

Introduction: In the surgical management of juvenile nasopharyngeal angiofibromas the possibility of recurrences and residual tumours is always there. This study was undertaken to predict the prognostic factors determining recurrence of juvenile nasopharyngeal angiofibroma and to find out the usual sites of these tumours.Material and methods: The medical records of 95 patients with histologically proven juvenile nasopharyngeal angiofibroma were reviewed retrospectively. The commonest surgical approach used was a combined transpalatal and transmaxillary approach with a lazy S incision. A conservative lateral infratemporal approach was used in three cases.Results: Complete removal of the juvenile nasopharyngeal angiofibroma was achieved in 78 (82 per cent) of the cases in a single operation. A residual tumour was found in 17 (18 per cent) cases and recurrences occurred in 13 (13.7 per cent) cases.Conclusions: Extensions into the pterygoid fossa and basisphenoid, erosion of the clivus, intracranial extensions medial to the cavernous sinus, invasion of the sphenoid diploe through a widened pterygoid canal, feeders from the internal carotid artery, a young age and a residual tumour were risk factors found associated with recurrence of juvenile nasopharyngeal angiofibroma.

scholarly journals Nasomaxillary Swing - A Novel Approach for Bilateral Angiofibroma

2009 ◽  
Vol 2 (3) ◽  
pp. 33-36 ◽  
Author(s):  
Alok Thakar ◽  
Gaurav Gupta ◽  
Mohnish Grover
Keyword(s):  
High Risk ◽  
Infratemporal Fossa ◽  
Complete Removal ◽  
Adolescent Males ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Nasopharyngeal Angiofibroma ◽  
Surgical Exposure ◽  
Novel Approach ◽  
High Risk Tumor

Abstract Juvenile nasopharyngeal angiofibroma (JNA) is a high-risk tumor of adolescent males. Choice of the approach should be based on the stage and site of the lesion. For complete removal of tumor, surgical exposure must be adequate. We here present a case of nasopharyngeal angiofibroma with intracranial and bilateral infratemporal fossa extension in which tumor was completely excised by nasomaxillary swing approach.

Facing a Feared Situation: Endoscopic Endonasal Approach for Petroclival Lesions With Internal Carotid Artery Encasement: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Yury Anania ◽  
Andrew S Venteicher ◽  
Eric W Wang ◽  
George A Zenonos ◽  
Carl H Snyderman ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Single Photon ◽  
Photon Emission ◽  
Complete Removal ◽  
Emission Computed Tomography ◽  
Endoscopic Endonasal ◽  
Cavernous Sinus Invasion ◽  
Cranial Nerve Palsies

Abstract A 33-yr-old woman presented with diplopia due to partial III and VI cranial nerve palsies, and an magnetic resonance imaging (MRI) showed a left petroclival lesion with cavernous sinus invasion. The ipsilateral internal carotid artery (ICA) was displaced and encased by the tumor. Chondroid tumors such as this are known to be high risk for ICA injury1; however, given the patient's young age a radical resection was desirable,2 depending on the risk of such a strategy. Therefore, a preoperative balloon test occlusion (BTO) was performed to estimate the risk of stroke in case of ICA sacrifice.3 Clinical and single-photon emission computed tomography testing predicted low risk of stroke, allowing for aggressive resection. A preoperative ICA occlusion was not performed as intraoperative control was believed to be adequate and preservation is always preferable when possible due to rare inaccuracies in BTO and long term risks of occlusion. An endoscopic endonasal and right contralateral transmaxillary approach with intraoperative neurophysiology were performed to remove this lesion.4,5 During surgery, the ICA proved dehiscent, and was therefore clip sacrificed.6 An immediate postoperative digital subtraction angiography showed minimally delayed, but adequate, blood flow to the left cerebral hemisphere. Postoperative MRI showed complete removal and no significant infarct. The patient was discharged in stable neurological condition, with only a slightly worsened CN III palsy. Experience with management of ICA injury is of uttermost importance in endoscopic endonasal surgery,1,2 and requires adequate training and an experienced 2-surgeon team.7 The patient provided consent to the submission and publication of the related surgical video.

scholarly journals Juvenile Nasopharyngeal Angiofibroma-Evaluation of the Invasion of the Pterygoid Canal-

2012 ◽  
Vol 115 (11) ◽  
pp. 965-970 ◽  
Author(s):  
Suetaka Nishiike ◽  
Takashi Shikina ◽  
Hidenori Maeda ◽  
Sachiko Hio ◽  
Hidenori Inohara
Keyword(s):  
Juvenile Nasopharyngeal Angiofibroma ◽  
Nasopharyngeal Angiofibroma ◽  
Pterygoid Canal

scholarly journals Juvenile Nasopharyngeal Angiofibroma

2021 ◽  
Vol 14 (1) ◽  
pp. 4
Author(s):  
Ibrahim Irsan Nasution ◽  
Ajeng Dyah Ayu WP
Keyword(s):  
Ct Scan ◽  
Clinical Symptoms ◽  
Pterygopalatine Fossa ◽  
Benign Tumour ◽  
Radiological Examination ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Tumour Stage ◽  
Nasopharyngeal Angiofibroma ◽  
Pterygoid Canal ◽  
Rare Benign Tumour

Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumour affecting mostly adolescent and can be malignant because it’s aggressive, destructive, spread locally and often extends to the skull. The exact cause of JNA is unknown. JNA originates from the pterygopalatine fossa at the aperture of the pterygoid canal. Clinical symptoms include nasal obtruction, epistaxis and headaches. The diagnosis is based on anamnesia, physical and radiological examination. CT scan and MRI are the main modalities in detecting and determining tumour stage.

scholarly journals Juvenile Nasopharyngeal Angiofibroma: Correlating Histology, Surgical Approach and Blood Loss

2015 ◽  
Vol 8 (2) ◽  
pp. 47-52
Author(s):  
RG Aiyer ◽  
Rahul R Gupta ◽  
Prarthna J Jagtap ◽  
Tanuj Thapar
Keyword(s):  
Blood Loss ◽  
Surgical Approach ◽  
Surgical Excision ◽  
Complete Removal ◽  
Vascular Tumor ◽  
Growth Patterns ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
Nasopharyngeal Angiofibroma

ABSTRACT Juvenile nasopharyngeal angiofibroma (JNA) is locally destructive benign vascular tumor for which surgical excision has always been the treatment of choice, in spite of the availability of various other treatment modalities. Complete removal at the maiden attempt has always been the key to a successful outcome. Recurrences (or rather residuals) discourage both the surgeon and patient. This prospective study was carried out in the Department of Otorhinolaryngology, Sir Sayajirao General Hospital, Vadodara, Gujarat, between August 2002 and 2015. We have studied 28 patients with JNA for growth patterns, histological characteristics and to compare various surgical modalities. Besides other investigations a detailed histological examination of the tumor was performed which suggested that as the tumor ages, the stroma predominates and the vessels are compressed into slits. In actively growing tumor the vascular component predominates. The percentage of open vascular channels is directly proportional to the bleeding while the intervascular fibrosis is inversely related. Surgical excision of JNA is the preferred modality of treatment. Surgical approach is sometimes the most tricky decision. Choosing the right approach is akin to walking on the thin rope with adequate exposure on one side and postoperative scar on the other. How to cite this article Thapar T, Gupta RR, Jagtap PJ, Aiyer RG. Juvenile Nasopharyngeal Angiofibroma: Correlating Histology, Surgical Approach and Blood Loss. Clin Rhinol An Int J 2015;8(2):47-52.

Juvenile nasopharyngeal angiofibroma: a single centre's 11-year experience

2018 ◽  
Vol 132 (11) ◽  
pp. 978-983 ◽  
Author(s):  
A E Pamuk ◽  
S Özer ◽  
A E Süslü ◽  
A Akgöz ◽  
M Önerci
Keyword(s):  
Recurrence Rate ◽  
Endoscopic Surgery ◽  
Medical Records ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Advanced Stage ◽  
Operative Blood Loss ◽  
Nasopharyngeal Angiofibroma ◽  
Male Patients ◽  
Extreme Care ◽  
Transnasal Endoscopic Surgery

AbstractObjectiveThis study aimed to present the clinical features and surgical outcomes of juvenile nasopharyngeal angiofibroma patients who were surgically treated.MethodsThe medical records of 48 male patients histologically confirmed as having juvenile nasopharyngeal angiofibroma, who underwent transnasal endoscopic surgery between 2005 and 2016, were retrospectively reviewed.ResultsThe overall recurrence rate was 20.8 per cent; however, the recurrence rate differed significantly between patients diagnosed aged less than 14 years (34.7 per cent) and more than 14 years (8 per cent) (p < 0.05). Advanced-stage tumours (Radkowski stage of IIC or more, and Önerci stage of III or more) were more aggressive than earlier stage tumours (p < 0.05 and p < 0.01, respectively). Pre-operative embolisation significantly prolonged mean hospitalisation duration, but had no effect on intra-operative blood loss in patients with advanced-stage tumours (p < 0.001 and p = 0.09, respectively).ConclusionThe findings show that transnasal endoscopic surgery could be considered the treatment of choice for juvenile nasopharyngeal angiofibroma. Patients diagnosed when aged less than 14 years and those with advanced-stage tumours are at risk of recurrence, and should be monitored with extreme care.

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