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Endonasal endoscopic resection of juvenile nasopharyngeal angiofibroma.
Rhinology 2007; 45(1):24-30R

Abstract

Juvenile angiofibroma (JNA) is a rare benign but locally aggressive tumour of the nasopharynx that primarily occurs in adolescent males. We report a series of 6 consecutive cases operated by exclusive endoscopic approach between from March 1996 and June 2003. All were male. The mean age was 17.2 years old (range: 11-23 years). The tumour involved the nasopharynx in all the cases (6/6), the sphenoid sinus (3/6) and the medial part of the pterygopalatine fossa (4/6). According to Radkowski's classification (Table 1), one patient was stage Ia, one was stage Ib and four patients were stage IIb. The mean duration of the surgery was 2 hours. The mean intraoperative blood loss was 575 ml despite a preoperative hyperselective embolization. The mean follow-up after the first operation was 67 months. All patients but one were free of disease. One patient had a recurrence in the nasopharynx and sphenoid sinuses requiring a successful revision procedure 3 years after the primary surgery. Another patient presented with a 5 mm non-symptomatic nodule in the pterygopalatine fossa, regressing on MRI during the 4 years following the surgery. In conclusion, endoscopic resection of JNA is a difficult but effective operation in experienced hands. Based upon the recent international literature, endonasal surgery combined with a preoperative embolization of the arterial supply is indicated for small and middle size JNAs but also for large tumours extended to the pterygopalatine fossa and medial aspect of the infratemporal fossa. Minimal intracranial extension is not an absolute contraindication if there is no clinical or radiological involvement of the cavernous sinus. A tridimentional guiding system can be of some help in large tumours.

Authors+Show Affiliations

Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Mont-Godinne, Université Catholique de Louvain, 5530-Yvoir, Belgium. philippe.eloy@orlo.ucl.ac.be

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17432065

Citation

Eloy, Ph, et al. "Endonasal Endoscopic Resection of Juvenile Nasopharyngeal Angiofibroma." Rhinology, vol. 45, no. 1, 2007, pp. 24-30.
Eloy P, Watelet JB, Hatert AS, et al. Endonasal endoscopic resection of juvenile nasopharyngeal angiofibroma. Rhinology. 2007;45(1):24-30.
Eloy, P., Watelet, J. B., Hatert, A. S., de Wispelaere, J., & Bertrand, B. (2007). Endonasal endoscopic resection of juvenile nasopharyngeal angiofibroma. Rhinology, 45(1), pp. 24-30.
Eloy P, et al. Endonasal Endoscopic Resection of Juvenile Nasopharyngeal Angiofibroma. Rhinology. 2007;45(1):24-30. PubMed PMID: 17432065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endonasal endoscopic resection of juvenile nasopharyngeal angiofibroma. AU - Eloy,Ph, AU - Watelet,J B, AU - Hatert,A S, AU - de Wispelaere,J, AU - Bertrand,B, PY - 2007/4/17/pubmed PY - 2007/7/10/medline PY - 2007/4/17/entrez SP - 24 EP - 30 JF - Rhinology JO - Rhinology VL - 45 IS - 1 N2 - Juvenile angiofibroma (JNA) is a rare benign but locally aggressive tumour of the nasopharynx that primarily occurs in adolescent males. We report a series of 6 consecutive cases operated by exclusive endoscopic approach between from March 1996 and June 2003. All were male. The mean age was 17.2 years old (range: 11-23 years). The tumour involved the nasopharynx in all the cases (6/6), the sphenoid sinus (3/6) and the medial part of the pterygopalatine fossa (4/6). According to Radkowski's classification (Table 1), one patient was stage Ia, one was stage Ib and four patients were stage IIb. The mean duration of the surgery was 2 hours. The mean intraoperative blood loss was 575 ml despite a preoperative hyperselective embolization. The mean follow-up after the first operation was 67 months. All patients but one were free of disease. One patient had a recurrence in the nasopharynx and sphenoid sinuses requiring a successful revision procedure 3 years after the primary surgery. Another patient presented with a 5 mm non-symptomatic nodule in the pterygopalatine fossa, regressing on MRI during the 4 years following the surgery. In conclusion, endoscopic resection of JNA is a difficult but effective operation in experienced hands. Based upon the recent international literature, endonasal surgery combined with a preoperative embolization of the arterial supply is indicated for small and middle size JNAs but also for large tumours extended to the pterygopalatine fossa and medial aspect of the infratemporal fossa. Minimal intracranial extension is not an absolute contraindication if there is no clinical or radiological involvement of the cavernous sinus. A tridimentional guiding system can be of some help in large tumours. SN - 0300-0729 UR - https://www.unboundmedicine.com/medline/citation/17432065/Endonasal_endoscopic_resection_of_juvenile_nasopharyngeal_angiofibroma_ L2 - https://www.rhinologyjournal.com/Abstract.php?id=615 DB - PRIME DP - Unbound Medicine ER -