Surgical Experience with Juvenile Nasopharyngeal Angiofibroma

1989 ◽  
Vol 98 (4) ◽  
pp. 269-272 ◽  
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.

Successful Repair of Large Skull Base Defect Following JNA Excision

2010 ◽  
Vol 3 (1) ◽  
pp. 49-52
Author(s):  
Alok Thakar ◽  
Gaurav Gupta ◽  
Mohnish Grover
Keyword(s):  
Skull Base ◽  
Free Flap ◽  
Surgical Excision ◽  
Vascular Tumor ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Intracranial Extension ◽  
Nasopharyngeal Angiofibroma ◽  
Young Males ◽  
Skull Base Defect ◽  
Successful Repair

Abstract Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular tumor of young males. Surgical excision remains the principal modality of treatment. Tumors with intracranial extension may require major surgical resections which are not devoid of complications. We here present a case of JNA with massive intracranial extension with postsurgery huge skull base defect with resultant encephalocele which was repaired successfully using rectus abdominis free flap.

Removal of Intracranial Extension of Juvenile Nasopharyngeal Angiofibroma by the Transfacial Approach

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Philippe Herman ◽  
Romain Kania ◽  
Emmanuel Bayonne ◽  
Wissame Bakkourri ◽  
Patrice Tran Ba Huy
Keyword(s):  
Juvenile Nasopharyngeal Angiofibroma ◽  
Intracranial Extension ◽  
Nasopharyngeal Angiofibroma

Treatment of Large Juvenile Nasopharyngeal Angiofibroma

1992 ◽  
Vol 106 (3) ◽  
pp. 278-282 ◽  
Author(s):  
Daniel G. Deschler ◽  
Michael J. Kaplan ◽  
Roger Boles
Keyword(s):  
Magnetic Resonance ◽  
External Carotid Artery ◽  
Magnetic Resonance Images ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Intracranial Extension ◽  
External Carotid ◽  
Nasopharyngeal Angiofibroma ◽  
Large Juvenile ◽  
Intracranial Disease ◽  
Preoperative Magnetic Resonance

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.

In defence of transpalatal, transpalatal-circumaxillary (transpterygopalatine) and transpalatal-circumaxillary-sublabial approaches to lateral extensions of juvenile nasopharyngeal angiofibroma

2016 ◽  
Vol 130 (5) ◽  
pp. 462-473 ◽  
Author(s):  
A Mishra ◽  
S C Mishra ◽  
V Verma ◽  
H P Singh ◽  
S Kumar ◽  
...  
Keyword(s):  
Residual Disease ◽  
Tumour Size ◽  
Infratemporal Fossa ◽  
Pterygopalatine Fossa ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Atrophic Rhinitis ◽  
Complete Excision ◽  
Nasopharyngeal Angiofibroma ◽  
Transpalatal Approach ◽  
Sublabial Approach

AbstractBackground:Juvenile nasopharyngeal angiofibroma often presents with lateral extensions. In countries with limited resources, selection of a cost-effective and least morbid surgical approach for complete excision is challenging.Methods:Sixty-three patients with juvenile nasopharyngeal angiofibroma, with lateral extensions, underwent transpalatal, transpalatal-circumaxillary (transpterygopalatine) or transpalatal-circumaxillary-sublabial approaches for resection. Clinico-radiological characteristics, tumour volume and intra-operative bleeding were recorded.Results:The transpalatal approach was suitable for extensions involving medial part of pterygopalatine fossa; transpalatal-circumaxillary for extensions involving complete pterygopalatine fossa, with or without partial infratemporal fossa; and transpalatal-circumaxillary-sublabial for extensions involving complete infratemporal fossa, even cheek or temporal fossa up to zygomatic arch. Haemorrhage was greatest with the transpalatal-circumaxillary-sublabial approach, followed by transpalatal approach and transpalatal-circumaxillary approach (1212, 950 and 777 ml respectively). Tumour size (volume) was greatest with the transpalatal-circumaxillary approach, followed by transpalatal-circumaxillary-sublabial approach and transpalatal approach (40, 34 and 29 mm3). There was recurrence in three cases and residual disease in two cases. Long-term morbidity included small palatal perforation (n = 1), trismus (n = 1) and atrophic rhinitis (n = 2).Conclusion:These modified techniques, performed with endoscopic assistance under hypotensive anaesthesia, without embolisation, offer a superior option over other open procedures with regard to morbidity and recurrences.

Trimodal embolization of juvenile nasopharyngeal angiofibroma with intracranial extension

2020 ◽  
Vol 130 ◽  
pp. 109805 ◽  
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

Juvenile nasopharyngeal angiofibroma with intracranial extension – diagnosis and treatment.

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.

scholarly journals Surgical management of juvenile nasopharyngeal angiofibroma using lateral rhinotomy: study of 80 cases

2011 ◽  
Vol 1 (2) ◽  
pp. 34
Author(s):  
Ninad Gaikwad ◽  
Nilam Sathe ◽  
Abhijeet Bhatia ◽  
Dhanashree Chiplunkar ◽  
Manoj Patil
Keyword(s):  
Infratemporal Fossa ◽  
The Body ◽  
The Other ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Lateral Rhinotomy ◽  
Temporal Fossa ◽  
Nasopharyngeal Angiofibroma ◽  
Lateral Skull Base ◽  
Operative Complications

A series of 80 patients with histopathologically confirmed juvenile nasopharyngeal angiofibroma were treated surgically over a period of ten years (1995-2004). The lateral rhinotomy approach was used to expose the tumor and its extensions. Lateral rhinotomy with its extensions provides wide exposure of and access to the nose, nasopharynx, paranasal sinuses, pterygopalatine fossa, infratemporal fossa and temporal fossa. Most intracranial, extradural extensions can also be approached. There were no major operative or post-operative complications. Longterm follow up from one to ten years showed only 8 recurrences. The added advantage of this approach is that it can be combined with all the other anterior and lateral skull base approaches. The cosmetic outcome is satisfactory if nasal aesthetic subunits are taken into considerations while making the incision. The lateral rhinotomy approach is the most direct route to the body of the tumor and can be used to approach all the possible extensions of the tumor.

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