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.

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 Endonasal Endoscopic Excision of Juvenile Nasopharyngeal Angiofibroma- The Technical Difficulties & Advantages

2014 ◽  
Vol 4 (2) ◽  
pp. 74-78
Author(s):  
Sudhangshu Shekhar Biswas ◽  
Zaheer Al Amin ◽  
Zaheer Al Amin ◽  
Rajashish Chakrabortty ◽  
Rajashish Chakrabortty ◽  
...  
Keyword(s):  
Blood Loss ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Endoscopic Management ◽  
Operative Blood Loss ◽  
Complete Excision ◽  
Nasopharyngeal Angiofibroma ◽  
Endoscopic Excision ◽  
First Choice ◽  
Hospital Stays ◽  
The Mean

Objective: Endoscopic excision of juvenile nasopharyngeal angiofibroma (JNA) was carried out with the objective of minimizing blood loss and attempting to complete excision of tumor under direct vision with the help of Hopkins telescope.Study design: A retrospective 12 year study of 6 cases of JNA treated by endoscopic excision is presented.Result: According to Radkowski’s classification, two patients were stage Ia, two were stage Ib and two patients were stage IIb. The mean duration of the surgery was 2 hours. The mean intra-operative blood loss was 575 ml. The mean follow –up after the primary operation was 23.3 months. All the patients but one were free of disease. One patient had a recurrence in the pterygopalatine fossa requiring a successful revision procedure 3 years after the primary surgery.Conclusion: Endoscopic resection of JNA is a difficult but effective operation in experienced hands. The endoscopic management had less intra operative blood loss, lower occurrence of complications, shorter length of hospital stays and lower rate of recurrence. So it should be considered as a first choice option.Birdem Med J 2014; 4(2): 74-78

scholarly journals Multidisciplinary management of juvenile nasopharyngeal angiofibroma

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Walid Abouzeid ◽  
Ahmed Sultan ◽  
Mohamed Shadad
Keyword(s):  
Blood Loss ◽  
Surgical Resection ◽  
Endoscopic Resection ◽  
Arterial Embolization ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Preoperative Embolization ◽  
Imaging Evaluation ◽  
Tissue Mass ◽  
Nasopharyngeal Angiofibroma ◽  
Male Patients

Abstract Background Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign, but the locally aggressive, vascular tumor that occurs almost exclusively in young men. Although this tumor accounts for only about 0.5% of head and neck tumors, it is by far the most common benign nasopharyngeal neoplasm. It is presented typically with epistaxis, obstructive symptoms, and chronic otomastoiditis. The examination of this tumor reveals pale reddish-blue mass. The tumor is seen on imaging as vividly augmenting soft-tissue mass centered on the sphenopalatine foramen. The treatment of choice is usually surgical resection; either open or endoscopic. Pre-operative embolization is usually done to help with hemostasis. We aim to address the efficiency and the safety of endovascular modality in JNA. Methods In the period between January 2012 to December 2017, 20 male patients with age ranging from 6 to 20 years were referred to the Endovascular Unit, at Departments of Neurosurgery in Sohag, Alexandria, and Tanta University Hospitals with JNF. Preoperative trans-arterial embolization was done, followed by endoscopic surgical resection by our ENT surgeons. All patients were subjected to clinical and radiological Imaging evaluation pre embolization, post embolization, and post endoscopic resection. All patients had clinical and radiological follow-ups for at least 1 year. Results 20 male patients with JNA underwent preoperative super-selective trans-arterial embolization. The average age at presentation was 13 years. All patients underwent successful embolization with total obliteration of vascular blush of the tumor in 15 patients, and near-total obliteration of blush in 5 patients. The dramatic effect of preoperative embolization was observed on limiting intraoperative blood loss (average 200 ml) and decreasing the time of surgery (average 2.5 h). There was no permanent morbidity or mortality related to either embolization or endoscopic resection in all patients. Conclusions Trans-arterial embolization is strongly recommended in patients with JNA, it offers a good assist to the surgeon, reduces blood loss, decreases the amount of transfusion, improves the degree of resection, reduces operative time, and decreases the incidence of recurrence.

Transnasal endoscopic surgery in juvenile nasopharyngeal angiofibroma

1996 ◽  
Vol 110 (10) ◽  
pp. 962-968 ◽  
Author(s):  
Reda H. Kamel
Keyword(s):  
Computed Tomography ◽  
Nasal Cavity ◽  
Endoscopic Surgery ◽  
Residual Tumour ◽  
Nasopharyngeal Angiofibroma ◽  
Endoscopic Control ◽  
Transnasal Endoscopic Approach ◽  
The Right ◽  
Transnasal Endoscopic Surgery

AbstractA case of angiofibroma limited to the right posterior nasal cavity, nasopharynx, and pterygopalatine fossa was operated upon transnasally under endoscopic control. The tumour was completely excised without complications. Endoscopic follow-up for the next two years and contrast computed tomography (CT) excluded any residual tumour or recurrence. The advantages, limitations and possible complications of this approach are discussed. It seems that in limited lesions of angiofibroma, the option of a transnasal endoscopic approach could be cautiously considered by experienced surgeons.

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