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.

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.

Transnasal microscopic approach for juvenile nasopharyngeal angiofibroma

2018 ◽  
Vol 72 (5) ◽  
pp. 31-36 ◽  
Author(s):  
Wiesław Gołąbek ◽  
Anna Szymańska ◽  
Kamal Morshed
Keyword(s):  
Infratemporal Fossa ◽  
Surgical Excision ◽  
Vascular Tumor ◽  
Stage I ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Preoperative Embolization ◽  
Stage Iiia ◽  
Nasopharyngeal Angiofibroma ◽  
Feeding Vessels

Introduction: Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign, vascular tumor originating in the nasopharynx. The treatment of choice for JNA is surgical excision. In recent years, surgical management has been greatly influenced by the use of the transnasal endoscopic technique. The aim: The aim of the study was to present our experience with the transnasal microscopic removal of JNA. Material and methods: Ten patients with JNA aged 12-17 underwent diagnostics imaging and transnasal microscopic tumor excision. Medical records of patients were retrospectively reviewed. The main outcome measures were complications and recurrences. Preoperative embolization of feeding vessels was performed in 7 patients. Results: According to Andrews’ classification, the group included 2 stage I patients, 6 stage II patients and 2 stage IIIA patients with the extensive occupation of the infratemporal fossa. 9 patients had no recurrence in 6-11 years follow up. One stage IIIA patient had a recurrence posteriorly to the pterygopalatine process and it was completely removed. No complications during or after surgery occurred. Conclusion: Transnasal microscopic excision is an effective approach to resect stage I-IIIA JNA

scholarly journals Radiation-Induced Sarcoma Originating in Recurrent Juvenile Nasopharyngeal Angiofibroma

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Smriti Panda ◽  
Madhu Rajeshwari ◽  
Chirom Amit Singh ◽  
Suresh C. Sharma ◽  
Pirabu Sakthivel
Keyword(s):  
Surgical Excision ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
External Beam Radiation ◽  
Definitive Treatment ◽  
Beam Radiation ◽  
Nasopharyngeal Angiofibroma ◽  
Young Males ◽  
Tumour Extension ◽  
Complete Surgical Excision ◽  
Radiation Induced

Juvenile nasopharyngeal angiofibroma is a benign disease affecting young males with a propensity to invade intracranially and into the orbit along preformed pathways. Complete surgical excision is the mainstay of management. Patients with multiple recurrences along with tumour extension into skull base and orbit can be considered for external beam radiation as either adjuvant or definitive treatment. Possibility of radiation-induced malignancy has been speculated by many authors, proof of which exists in only two studies so far. This report focuses on radiation-induced leiomyosarcoma in a patient with recurrent juvenile nasopharyngeal angiofibroma.

scholarly journals Trend analysis in management of juvenile nasopheryngeal angiofibroma: our institutional experience

2019 ◽  
Vol 6 (1) ◽  
pp. 94
Author(s):  
Heli H. Vasani ◽  
Chinmayee P. Joshi ◽  
Kalpesh B. Patel
Keyword(s):  
Surgical Excision ◽  
Vascular Tumor ◽  
Endoscopic Approach ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Surgical Approaches ◽  
Open Approach ◽  
Nasopharyngeal Angiofibroma ◽  
Endoscopic Method ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Juvenile nasopharyngeal angiofibroma is a vascular malformation rather than true neoplasm. It accounts for 0.5% of all head and neck tumors and its general incidence is 1:150,000. It is uncommon, benign, extremely vascular tumor that arises from tissues in the sphenopalatine foramen, the pterygoid base causing Early spread submucosally towards nasopharynx. Surgical excision is mainstay of treatment.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective observational study carried out from March 2002 to March 2019, 130 patients underwent surgical resection of juvenile nasopharyngeal angiofibroma at Civil Hospital, Ahmedabad. Patients were divided in two groups with Group-A having patients from 2002-2010 and Group B having patients from 2011-2019.</p><p class="abstract"><strong>Results:</strong> A total 130 cases of juvenile nasopharyngeal angiofibroma with a mean age of 16.25 years (range 9-33) were treated by surgical excision from March 2002 to March 2019. In Group A patients open approach was used most often with endoscopic approach used only till stage II-A. In Group B patients the preferred surgical approach was trans-nasal endoscopic approach cases up to stage IV-A and open approach including the midfacial degloving approach and infratemporal approach was used cases with extensive intracranial, lateral infratemporal fossa, orbit, optic nerve, cavernous sinus involvement.</p><p class="abstract"><strong>Conclusions:</strong> Our study shows that over the years there has been shift in surgical approaches used in treating angiofibroma with the advent of newer endoscopic method and addition of various technology such as coblation, navigation has made the procedure for a highly vascular tumor simpler.</p><p class="abstract"> </p>

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.

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.

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