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Bove I, Pangal DJ, Ruzevick JJ, Cheok S, Amar A, Mack W, Ference ED, Wrobel B, Swanson M, Hur K, Zada G. Anatomic Considerations Guiding Single Versus Multiportal Endoscopic Approaches for Resection of Juvenile Nasopharyngeal Angiofibroma: Cases Series With Graded Multicorridor Resections. Oper Neurosurg (Hagerstown) 2023; 25:150-160. [PMID: 37166983 DOI: 10.1227/ons.0000000000000709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/08/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Juvenile nasopharyngeal angiofibromas (JNAs) are characterized by expansive and destructive growth, often invading the midline/paranasal sinuses, pterygopalatine fossa, and infratemporal fossa and can extend into the orbit, cavernous sinus, or intracranially. OBJECTIVE To evaluete the major benefits of the extended endoscopic endonasal approach (EEA) for JNA resection as compared with more traditional and invasive transpalatal and transfacial approaches. When JNAs extend into lateral anatomic compartments, the optimal operative trajectory often requires additional approach strategies or surgical staging. METHODS We retrospectively reviewed 8 cases of large JNAs arising in symptomatic adolescent boys (University of Pittsburgh Medical Center Stages II, III, and V) and discuss anatomic and tumor considerations guiding the decision of a pure EEA vs combined EEA and sublabial transmaxillary approach (Caldwell-Luc). RESULTS A pure extended EEA was used in 6 JNA cases (UPMC Stages II-III); a multiportal EEA + Caldwell-Luc maxillotomy was used in 2 cases. One of the 2 patients (UPMC Stage V) previously treated with multiportal EEA + Caldwell-Luc maxillotomy underwent staged left temporal/transzygomatic craniotomy, obtaining gross total resection. Seven patients ultimately underwent complete removal without recurrence. One patient with a small residual JNA (UPMC II) underwent stereotactic radiosurgery without progression to date. CONCLUSION JNAs with lateral extension into the infratemporal fossa often benefited from additional lateral exposure using a Caldwell-Luc maxillotomy. Cases with significant skull base and/or dural involvement may undergo staged surgical treatment; temporalis + transzygomatic craniotomy is often useful for second-stage approaches for residual tumor in these lateral infratemporal or intracranial regions. SRS should be considered for residual tumor if additional surgery is not warranted.
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Affiliation(s)
- Ilaria Bove
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Dhiraj J Pangal
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Jacob J Ruzevick
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Stephanie Cheok
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Arun Amar
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - William Mack
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Elisabeth D Ference
- USC Caruso Department of Otolaryngology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Bozena Wrobel
- USC Caruso Department of Otolaryngology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Mark Swanson
- USC Caruso Department of Otolaryngology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Kevin Hur
- USC Caruso Department of Otolaryngology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Gabriel Zada
- Department of Neurological Surgery, The University of Southern California Keck School of Medicine, Los Angeles, California, USA
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Llorente JL, López F. The endoscopic endonasal approach for the treatment of juvenile angiofibromas. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019; 70:136-144. [PMID: 29764608 DOI: 10.1016/j.otorri.2018.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 01/13/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Juvenile angiofibroma (JA) is a benign tumour, for which the treatment of choice is surgery. It may be associated with significant morbidity because of its anatomical location and its locally destructive growth pattern. Severe haemorrhage constitutes a high risk in JA and its surgical management can be complex. The management of JA remains a challenge. The objective of this study was to review a series of patients with JA treated via the endonasal/endoscopic approach. MATERIAL AND METHODS Medical records of patients operated for JA were reviewed. MAIN OUTCOME MEASURES tumour stage, intraoperative blood loss, complications and persistence/recurrence rates. RESULTS A total of 30 male patients and one female were included. The mean age was 17 years. Using the Radkowski classification, one JA was classified as stage I, 5 stage IIA, 9 stage IIB, 4 stage IIC, 10 stage IIIA and 2 stage IIIB. Thirty-nine percent of the JA was classified as advanced stage JA (IIIA and IIIB). The mean blood loss was 1.156mL Except in one case, no significant complications were observed. Tumour persistence/recurrence was observed in 2 JA (6%), at the end of the follow-up. Mean postoperative follow-up time was 86 months. CONCLUSIONS This retrospective study supports the notion that endonasal endoscopic approaches for a JA are a feasible option associated with good long-term results.
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Affiliation(s)
- José Luis Llorente
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España.
| | - Fernando López
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, España
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The Endoscopic Endonasal Approach for the Treatment of Juvenile Angiofibromas. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019. [DOI: 10.1016/j.otoeng.2018.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Analysis of Surgical Approaches to Skull Base Tumors Involving the Pterygopalatine and Infratemporal Fossa. J Craniofac Surg 2019; 30:589-595. [DOI: 10.1097/scs.0000000000005108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Rupa V, Mani SE, Backianathan S, Rajshekhar V. Management and Outcome in Patients with Advanced Juvenile Nasopharyngeal Angiofibroma. J Neurol Surg B Skull Base 2018; 79:353-360. [PMID: 30009116 PMCID: PMC6043168 DOI: 10.1055/s-0037-1608658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/30/2017] [Indexed: 10/18/2022] Open
Abstract
Objective To report the management outcome in a series of patients with advanced juvenile nasopharyngeal angiofibroma (JNA). Design Retrospective study. Setting Tertiary care teaching hospital. Participants Forty-five patients classified as Radkowski stage IIIA or IIIB who presented to us over the past 10 years. Main Outcome Measures Surgical approaches used and disease free outcomes in patients with advanced JNA. Results Surgical access for the extracranial component included open (41.9%) and expanded endonasal approaches (58.1%). Craniotomy (16.3%), endoscopy-assisted open approach (7%), or expanded endonasal approach (20.9%) was performed to excise the skull base or intracranial component. Follow up ranged from 4 to 96 months (mean, 20.3 months). Of 35 patients who underwent imaging at the first postoperative follow up, 25 (71.4%) had negative scans. Three symptomatic patients with residual disease underwent endoscopic excision and had negative scans thereafter. Of two others who had radiation therapy, one was disease free and the other lost to follow up. Five others had stable, residual disease. Three patients (8.6%) with recurrent disease underwent surgical excision, of whom two had minimal, stable residual disease. At the last follow-up, 27 (77.1%) patients had negative scans, and 7 (20%) had stable residual disease with one (2.9%) patient lost to follow-up. Conclusions Advanced JNA may be successfully treated in most cases with expanded endonasal/endoscopy assisted ± craniotomy approach after appropriate preoperative evaluation. At follow-up, only symptomatic patients or those with enlarging residue require treatment; periodic imaging surveillance is adequate for those with stable disease.
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Affiliation(s)
- Vedantam Rupa
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | - Vedantam Rajshekhar
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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López F, Triantafyllou A, Snyderman CH, Hunt JL, Suárez C, Lund VJ, Strojan P, Saba NF, Nixon IJ, Devaney KO, Alobid I, Bernal-Sprekelsen M, Hanna EY, Rinaldo A, Ferlito A. Nasal juvenile angiofibroma: Current perspectives with emphasis on management. Head Neck 2017; 39:1033-1045. [PMID: 28199045 DOI: 10.1002/hed.24696] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/03/2016] [Accepted: 12/06/2016] [Indexed: 12/12/2022] Open
Abstract
Juvenile angiofibroma is an uncommon, benign, locally aggressive vascular tumor. It is found almost exclusively in young men. Common presenting symptoms include nasal obstruction and epistaxis. More advanced tumors may present with facial swelling and visual or neurological disturbances. The evaluation of patients with juvenile angiofibroma relies on diagnostic imaging. Preoperative biopsy is not recommended. The mainstay of treatment is resection combined with preoperative embolization. Endoscopic surgery is the approach of choice in early stages, whereas, in advanced stages, open or endoscopic approaches are feasible in expert hands. Postoperative radiotherapy (RT) or stereotactic radiosurgery seem valuable in long-term control of juvenile angiofibroma, particularly those that extend to anatomically critical areas unsuitable for complete resection. Chemotherapy and hormone therapy are ineffective. The purpose of the present review was to update current aspects of knowledge related to this rare and challenging disease. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1033-1045, 2017.
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Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, Spain
| | - Asterios Triantafyllou
- Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK.,School of Dentistry, University of Liverpool, Liverpool, UK
| | - Carl H Snyderman
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Carlos Suárez
- Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, Spain
| | - Valerie J Lund
- Professorial Unit, Ear Institute, University College London, London, UK
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Iain J Nixon
- Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, UK
| | | | - Isam Alobid
- Department of Otolaryngology, Hospital Clinic, University of Barcelona Medical School, Barcelona, Spain
| | - Manuel Bernal-Sprekelsen
- Department of Otolaryngology, Hospital Clinic, University of Barcelona Medical School, Barcelona, Spain
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
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Solomon D, Isaacson G. Transoral “Adenoidectomy” Excision of Juvenile Nasopharyngeal Angiofibromas. Ann Otol Rhinol Laryngol 2016; 116:243-7. [PMID: 17491520 DOI: 10.1177/000348940711600403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: We describe a minimally invasive technique for excision of selected juvenile nasopharyngeal angiofibromas (JNAs) using indirect visualization of the nasopharynx. Methods: An observational case series with follow-up of 9 months to 3 years was performed. The subjects included 4 teenage boys with early-stage nasopharyngeal angiofibromas. The intervention included computed tomography, magnetic resonance imaging, angiography and embolization, tumor excision, pathologic examination, and follow-up. The outcome measures included blood loss, perioperative morbidity, and surgical cure. Results: Four teenage boys underwent excision of early stage JNAs — 3 with preoperative embolization. The JNAs were excised under indirect mirror guidance with an adenoid curette and the nasopharynx packed. Residual tumor was removed endoscopically. The operative time was less than 1 hour in each case, and blood loss was less than 100 mL. All 4 boys are free of disease. Conclusions: With the advent of refined imaging techniques and relatively safe preoperative embolization, minimally invasive approaches to JNA excision have been advocated. Endoscopic transnasal piecemeal excision is feasible but time-consuming. Transoral avulsion of the tumor mass by adenoidectomy techniques combined with endoscopic removal of tumor remnants from the pterygopalatine fossa allows complete, controlled surgical excision with minimal blood loss.
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Affiliation(s)
- Don Solomon
- Department of Otolaryngology-Head and Neck Surgery, Temple University School of Medicine and Temple University Children's Medical Center, Philadelphia, Pennsylvania 19140, USA
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The combined subtemporal-transfacial approach for the resection of juvenile nasopharyngeal angiofibromas with intracranial extension. Otol Neurotol 2014; 36:151-5. [PMID: 25036780 DOI: 10.1097/mao.0000000000000498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Stage IVb juvenile nasopharyngeal angiofibromas (JNAs) are frequently regarded as unresectable because of their intracranial extension and cavernous sinus invasion. Although radiation has been described to control these tumors, it can leave the adolescent with long-lasting sequelae. Herein, we describe an alternative treatment strategy based on a combined subtemporal-transfacial surgical approach that permits the successful management of advanced stage JNAs by divorcing the intracranial vascular supply to these massive lesions. PATIENTS Four male patients were identified with Andrew's Stage IVB JNAs. INTERVENTION All patients were treated by surgical resection using a combined subtemporal-transfacial surgical approach. MAIN OUTCOME MEASURES Parameters assessed included tumor extent, number and types of surgical procedures, extent of resections, complications, and recurrence rate. RESULTS Near-total tumor resections were achieved in all patients. No cerebrospinal fluid leak or cranial neuropathies were noted. All but one patient had local recurrences, and these could be managed with repetitive endoscopic debridement. No patient required adjuvant radiation treatment to control advanced disease. CONCLUSIONS With the use of modern skull base surgical techniques, coordinated interdisciplinary care, and safe, near-total removal of the tumor mass, adolescent males with advanced JNAs may be spared the long-term morbidities associated with using radiation to treat these benign but aggressive lesions.
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Boghani Z, Husain Q, Kanumuri VV, Khan MN, Sangvhi S, Liu JK, Eloy JA. Juvenile nasopharyngeal angiofibroma: A Systematic Review and Comparison of Endoscopic, Endoscopic-Assisted, and Open Resection in 1047 Cases. Laryngoscope 2013; 123:859-69. [DOI: 10.1002/lary.23843] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 09/12/2012] [Accepted: 10/03/2012] [Indexed: 11/07/2022]
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Girish Rao S, Sudhakara Reddy K, Sampath S. Lefort I access for Juvenile Nasopharyngeal Angiofibroma (JNA): A prospective series of 22 cases. J Craniomaxillofac Surg 2012; 40:e54-8. [DOI: 10.1016/j.jcms.2011.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 12/28/2010] [Accepted: 03/01/2011] [Indexed: 11/30/2022] Open
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Blount A, Riley KO, Woodworth BA. Juvenile nasopharyngeal angiofibroma. Otolaryngol Clin North Am 2012; 44:989-1004, ix. [PMID: 21819885 DOI: 10.1016/j.otc.2011.06.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Juvenile nasopharyngeal angiofibromas (JNAs) are rare, benign, highly vascular, locally aggressive tumors that primarily affect male adolescents. Historical treatment of these neoplasms has been primarily surgical. In the past decade, endoscopic resection of JNAs has become a viable and promising surgical treatment option. Endoscopic resection has many advantages over traditional open techniques, including better cosmesis, decreased blood loss, shortened hospital stays, and equivalent or improved recurrence rates. Emerging endoscopic technology continues to push the boundaries of resection of skull base tumors and will no doubt become the surgical treatment of choice for most JNAs in the near future.
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Affiliation(s)
- Angela Blount
- Division of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, 563 Boshell Building, 1530 3rd Avenue South, Birmingham, AL 35294-0012, USA
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Kim AH, Governale LS, Kim DH, Black PM. The management of skull base tumors. HANDBOOK OF CLINICAL NEUROLOGY 2012; 105:657-664. [PMID: 22230525 DOI: 10.1016/b978-0-444-53502-3.00015-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Albert H Kim
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
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Llorente JL, López F, Suárez V, Costales M, Suárez C. Evolution in the Treatment of Juvenile Nasopharyngeal Angiofibroma. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2011. [DOI: 10.1016/j.otoeng.2011.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Evolución en el tratamiento de los angiofibromas nasofaríngeos juveniles. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2011; 62:279-86. [DOI: 10.1016/j.otorri.2011.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 02/02/2011] [Accepted: 02/08/2011] [Indexed: 11/19/2022]
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Gallia GL, Ramanathan M, Blitz AM, Reh DD. Expanded endonasal endoscopic approach for resection of a juvenile nasopharyngeal angiofibroma with skull base involvement. J Clin Neurosci 2010; 17:1423-7. [PMID: 20708935 DOI: 10.1016/j.jocn.2010.04.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Accepted: 04/08/2010] [Indexed: 11/20/2022]
Abstract
Juvenile nasopharyngeal angiofibromas (JNAs) are rare vascular tumors which arise in the nasopharynx of adolescent males. Patients with these tumors can be cured by surgery, which is the treatment of choice in the majority of patients. Traditional surgical techniques for patients with JNAs have been via open surgical approaches. Since 2000, however, the surgical management of JNAs has changed due to advances in endoscopic procedures and such approaches are standard for early stage lesions which are limited to the nasal cavity, nasopharynx and the paranasal sinuses. The role and limitations of endoscopic approaches for JNAs with skull base and intracranial involvement are being defined. In this report, we describe a patient with a JNA with skull base involvement who underwent an expanded endonasal endoscopic approach for a complete resection. Additionally, we review the literature of endoscopic approaches to JNAs with skull base involvement.
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Affiliation(s)
- Gary L Gallia
- Department of Neurosurgery and Oncology, Johns Hopkins Hospital, Phipps Building, Room 118, Baltimore, Maryland 21287, USA.
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Effect of embolisation on endoscopic resection of angiofibroma. The Journal of Laryngology & Otology 2010; 124:631-5. [DOI: 10.1017/s0022215109992726] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:To determine the effect of embolisation on endoscopic resection of angiofibroma.Subjects and method:A partially blinded trial was undertaken. Twenty-three patients with angiofibroma (nine embolised and 14 not embolised) underwent endoscopic resection between January 2007 and August 2008 in two tertiary referral centres. Demographic data were collected, the pre-operative tumour extent was assessed by computed tomography, and tumours were staged according to their computed tomography appearance (Radkowski scale). In addition, we evaluated the duration of surgery, amount of haemorrhage, blood pressure during surgery, duration of hospitalisation, complications of surgery and embolisation, cost of treatment, and number of post-operative recurrences, as well as the angiographic characteristics in the embolisation group.Results:There was no significant difference between the general characteristics of both groups. At the end of the study period, we could find no significant difference between the two groups regarding haemorrhage, number of recurrences or complications. The only significant difference was cost of treatment, which was significantly higher in the embolisation group.Conclusion:Endoscopic resection is a feasible and safe method for angiofibroma surgery. The current evidence does not support obligatory embolisation in every case of endoscopic angiofibroma resection.
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Albuquerque MAP, Carvalho DDC, Grandez D, Bonilla LF, Cavalcanti MGP. Nasopharyngeal angiofibroma. surgical approach using a transoral Le Fort I osteotomy following embolization: a case report. ACTA ACUST UNITED AC 2009; 107:180-4. [DOI: 10.1016/j.tripleo.2008.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 06/27/2008] [Accepted: 07/17/2008] [Indexed: 11/28/2022]
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Gołabek W, Szymańska A, Siwiec H, Trojanowski P. [Transpalatal approach for juvenile angiofibroma]. Otolaryngol Pol 2008; 62:16-9. [PMID: 18637415 DOI: 10.1016/s0030-6657(08)70202-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Juvenile nasopharyngeal angiofibromas (JNA) are highly vascular, locally invasive tumours which originate in the sphenopalatine foramen. Several surgical approaches are described for this tumour. The aim of this study was to evaluate the transpalatal approach for juvenile angiofibroma. MATERIAL AND METHODS In a group of 22 patients with JNA transpalatal approach was employed. A retrospective patients notes review was done. Extension of tumour, complications of surgery and recurrences were analyzed. RESULTS In 17 patients the tumour was confined to the nasal cavity and the nasopharynx. In 5 patients the tumour invaded the sphenoid sinus. No complications were observed after surgery. Two (9%) patients had recurrence. CONCLUSION Transpalatal approach is best suited to small tumours (Andrews grade I and II) limited to the nasopharynx, nasal cavity and sphenoid sinus.
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Affiliation(s)
- Wiesław Gołabek
- Klinika Otolaryngologii i Onkologii Laryngologicznej AM w Lublinie
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Fonseca AS, Vinhaes E, Boaventura V, de Andrade NA, Dias LA, Medeiros V, Coifman F. Surgical Treatment of Non-embolized Patients with Nasoangiofibroma. Braz J Otorhinolaryngol 2008; 74:583-7. [PMID: 18852986 PMCID: PMC9442087 DOI: 10.1016/s1808-8694(15)30607-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Accepted: 09/12/2007] [Indexed: 11/25/2022] Open
Abstract
Materials And Method Results Conclusion
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