Endoscopic Excision of Juvenile Nasopharyngeal Angiofibroma: A Case Series

OBJECTIVE: To report the loss of reflex tearing after surgical treatment of juvenile nasopharyngeal angiofibroma (JNA). STUDY DESIGN AND SETTING: A retrospective case series of 8 patients with surgical extirpation of JNA from 1995 to 2003 in a major teaching hospital setting was studied for symptomatic xerophthalmia. RESULTS: One patient was lost to follow-up. Four of the remaining 7 patients reported a dry ipsilateral eye after surgical treatment of JNA. CONCLUSION: The location of the pterygopalatine ganglion and its associated fibers in the pterygopalatine fossa is directly adjacent to the location of origin of JNA. Lacrimal innervation passes through the pterygopalatine ganglion. Given the extensive nature of advanced JNA and mandate for complete surgical excision, lacrimal dysfunction should be considered an expected consequence of surgery. SIGNIFICANCE: The loss of reflex tearing has not been reported as a consequence of JNA or its surgical treatment. EBM Rating: C.

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

BIRDEM Medical Journal ◽

10.3329/birdem.v4i2.33192 ◽

2014 ◽

Vol 4 (2) ◽

pp. 74-78

Author(s):

Sudhangshu Shekhar Biswas ◽

Zaheer Al Amin ◽

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 Radkowskis 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

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Endoscopic Excision of Juvenile Nasopharyngeal Angiofibroma: Case Series of 20 Patients

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2020.v28i1.177 ◽

2020 ◽

Vol 28 (1) ◽

pp. 76-79

Author(s):

Monil Parsana ◽

Kalpesh Patel ◽

Abhishek Gugliani

Keyword(s):

Case Series ◽

Endoscopic Approach ◽

Juvenile Nasopharyngeal Angiofibroma ◽

Recurrence Rates ◽

Nasopharyngeal Angiofibroma ◽

Young Males ◽

Medical College ◽

Recurrent Epistaxis ◽

Life Threatening ◽

Local Examination

Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a highly vascular, benign, locally aggressive tumour of the nasopharynx. Endoscopic approach is the current accepted modality for the excision of Juvenile Nasopharyngeal Angiofibroma. The current study was undertaken to assess the outcome of this procedure at our institute. Materials and Methods A total of 20 patients of JNA at a medical college in Ahmedabad between the period of July 2015 to July 2017 were included. The tumour was staged according to Fisch system and clinical presentation, local examination, nasal endoscopy findings, radiological findings, approach of surgical resection, complications and recurrence were noted. Results We found that endoscopic approach for the excision of juvenile nasopharyngeal angiofibroma is safe and effective technique associated with reduced post operative morbidity and low recurrence rates. Conclusions JNA is a rare but a potentially life-threatening disease. All young males presenting with profuse, spontaneous and recurrent epistaxis should be evaluated for JNA. Endoscopic approaches have become the procedure of choice for resection of these tumours.

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