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Juvenile nasopharyngeal angiofibroma with intracranial extension.
Otolaryngol Head Neck Surg. 2011 Sep; 145(3):498-504.OH

Abstract

OBJECTIVE

To provide a critical evaluation of the historical evolution of the surgical treatment of juvenile nasopharyngeal angiofibroma (JNA) with intracranial extension.

STUDY DESIGN

Case series with chart review.

SETTING

Skull base multidisciplinary group at the Instituto de Neurologia de Curitiba, Brazil.

SUBJECTS AND METHODS

From 1988 to 2000, the multidisciplinary skull base group surgically treated 67 adolescent boys with JNA, 20 of whom presented with intracranial extension. All patients presented involvement of the cavernous sinus, and 5 of them spread into the orbit. Before 2008, the authors combined microscopic-endoscopic techniques. After this period, the surgical approach used was facial degloving, associated with purely endoscopic technique patients.

RESULTS

Total tumor removal was achieved in 17 cases in the first surgery. In this series, the intracranial extension was extradural in all cases. There was only 1 case of cerebrospinal fluid leakage, which was promptly identified and treated. There was no mortality or permanent morbidity.

CONCLUSION

Radical removal of large JNA may be difficult because of its extreme vascularity and extension to the cavernous sinus, orbit, middle and anterior fossa. Nevertheless, most of JNA with intracranial extension can be resected in the first operation with minimal morbidity through a facial degloving and further combination of expanded endoscopic endonasal approaches.

Authors+Show Affiliations

Neurosurgery Department, Instituto de Neurologia de Curitiba, Brazil. tobiasmattei@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21572079

Citation

Mattei, Tobias Alecio, et al. "Juvenile Nasopharyngeal Angiofibroma With Intracranial Extension." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 145, no. 3, 2011, pp. 498-504.
Mattei TA, Nogueira GF, Ramina R. Juvenile nasopharyngeal angiofibroma with intracranial extension. Otolaryngol Head Neck Surg. 2011;145(3):498-504.
Mattei, T. A., Nogueira, G. F., & Ramina, R. (2011). Juvenile nasopharyngeal angiofibroma with intracranial extension. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 145(3), 498-504. https://doi.org/10.1177/0194599811408694
Mattei TA, Nogueira GF, Ramina R. Juvenile Nasopharyngeal Angiofibroma With Intracranial Extension. Otolaryngol Head Neck Surg. 2011;145(3):498-504. PubMed PMID: 21572079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Juvenile nasopharyngeal angiofibroma with intracranial extension. AU - Mattei,Tobias Alecio, AU - Nogueira,Gustavo Fabiano, AU - Ramina,Ricardo, Y1 - 2011/05/13/ PY - 2011/5/17/entrez PY - 2011/5/17/pubmed PY - 2011/10/28/medline SP - 498 EP - 504 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 145 IS - 3 N2 - OBJECTIVE: To provide a critical evaluation of the historical evolution of the surgical treatment of juvenile nasopharyngeal angiofibroma (JNA) with intracranial extension. STUDY DESIGN: Case series with chart review. SETTING: Skull base multidisciplinary group at the Instituto de Neurologia de Curitiba, Brazil. SUBJECTS AND METHODS: From 1988 to 2000, the multidisciplinary skull base group surgically treated 67 adolescent boys with JNA, 20 of whom presented with intracranial extension. All patients presented involvement of the cavernous sinus, and 5 of them spread into the orbit. Before 2008, the authors combined microscopic-endoscopic techniques. After this period, the surgical approach used was facial degloving, associated with purely endoscopic technique patients. RESULTS: Total tumor removal was achieved in 17 cases in the first surgery. In this series, the intracranial extension was extradural in all cases. There was only 1 case of cerebrospinal fluid leakage, which was promptly identified and treated. There was no mortality or permanent morbidity. CONCLUSION: Radical removal of large JNA may be difficult because of its extreme vascularity and extension to the cavernous sinus, orbit, middle and anterior fossa. Nevertheless, most of JNA with intracranial extension can be resected in the first operation with minimal morbidity through a facial degloving and further combination of expanded endoscopic endonasal approaches. SN - 1097-6817 UR - https://www.unboundmedicine.com/medline/citation/21572079/Juvenile_nasopharyngeal_angiofibroma_with_intracranial_extension_ L2 - http://journals.sagepub.com/doi/full/10.1177/0194599811408694?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -