Comparison between endoscopic and open surgery in 37 patients with nasopharyngeal angiofibroma

Oliveira, José Alberto Alves; Tavares, Marylane Galvão; Aguiar, Carolina Veras; Azevedo, Jorge Ferreira; Sousa, João Renato F.; Almeida, Paulo César de; Gomes, Eymeric

doi:10.1590/s1808-86942012000100012

Cited by 11 publications

(9 citation statements)

References 12 publications

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“…So, preoperative embolization of feeder vessels i.e., super selective embolization of external carotid artery can be done to reduce blood loss without significant neurological complications [8]. There is no definite benefit of transarterial over direct tumoural embolization [9].…”

Section: Discussionmentioning

confidence: 99%

Juvenile Nasopharyngeal Angiofibroma: A Case Report

Acharya

Naik

Panditray

et al. 2017

JCDR

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A 18-year-old male presented with chief complains of nasal obstruction which was unilateral (left), progressive, epistaxis, continuing nasal discharge since two months, with a mass in his nasal cavity. He had intermittent headache which used to be relieved by simple analgesics with nasal bleeding episodes that lasted for 10-15 minutes actively and serous discharge pervasive over a two month period. On presentation, he had one episode of painless epistaxis, loosing approximately 40-50 ml of blood, for which he was referred to our centre. Past history reveals no episodes of nasal bleeding before two months but intermittent nasal discharge. Patient had no clinical pallor but mouth breathing was evident, specifically complained during sleep. Endoscopic examination of the nose reveals that the mass was congested, compressible, filling the left inferior and middle meatus, extending back filling the choana with active serous discharge with tinges of blood clots, probably from previous nasal bleed [Table/ Fig-1]. There was no tenderness on palpation and no external facial deformity. Probe test revealed no attachments in the nasal cavity. On posterior rhinoscopy the mass could be seen extending to nasopharynx in the region of fossa of rosenmuller and beyond.The oro-dental examination was normal. General examination revealed no significant abnormality. Routine haematological investigations were found to be within the normal limits. Fine-needle aspiration was carried out with caution in an operating room and revealed only blood. Computed tomography revealed a non-encapsulated lobulated heterogeneous soft tissue dense mass lesion taking significant enhancement on Intra Venous (IV) contrast injection, in naso-pharynx and left posterior choana of the nasal cavity, extending upto pterygopalatine and infratemporal fossa, masseter space of left side and involving the pterygoid muscles; ipsilateral sphenoid sinus and posterior ethmoid cells were also infiltrated. There was anterior bowing of posterior wall of ipsilateral maxillary sinus. The osteomeatal complex was invaded with erosion of the middle and inferior turbinate [Table/ Fig-2].Post-operative period was uneventful. The patient was discharged after three days. On follow up nasal endoscopy was done after 15 days and after three months. Nasal cavity was healthy and no signs of recurrence was seen. Surgical ProcedureThe surgery was done under general hypotensive anaesthesia with patient in supine reverse Trendelenberg [1] position and intraoral delivery of endotracheal tube. Keywords: Embolization, Midfacial degloving, Vascular tumours AbSTRACTJuvenile nasopharyngeal angiofibroma is tumour almost exclusively seen in adolescent males, constituting less than 1% of all neoplasms in head and neck. They are benign and locally spreading and are highly vascular in nature and thus prove to be a surgical challenge because of its complex anatomical location. Here, we present a case report of a 18-year-old male presenting with a mass in his left nasal cavity, with recurrent epistaxis ...

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Section: Discussionmentioning

confidence: 99%

Juvenile Nasopharyngeal Angiofibroma: A Case Report

Acharya

Naik

Panditray

et al. 2017

JCDR

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“…However, it could give us some comparative information. Moreover, we reviewed all the studies 7-24,31…”

Section: Discussionmentioning

confidence: 99%

“…However, it could give us some comparative information. Moreover, we reviewed all the studies 7‐24,31‐104 that reported on the endoscopic treatment of JNA, including case reports and studies lacking some information such as follow‐up, recurrence, or staging. We considered that in the absence of a comparative intension, a descriptive systematic review should include all the cases reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Exclusive Endoscopic Resection of Juvenile Nasopharyngeal Angiofibroma: A Systematic Review of the Literature

Khoueir¹,

Nicolas²,

Rohayem³

et al. 2013

Otolaryngol.--head neck surg.

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“…Progress in equipment means endoscopic surgeons can tackle progressively larger and more invasive lesions, such as some Radkowski type IIIa tumours or involving the orbit, the infratemporal fossa and the parasellar region, which are no longer considered absolute contraindications 1,28 . An endoscopic approach is preferable to open surgery because it ensures a better visualisation of the tumour margins, which translates to a more accurate dissection, less bleeding, less frequently requiring transfusion; other advantages include a shorter duration of surgery, smaller impact on craniofacial growth, no aesthetic defect and fewer complications 29 . En-bloc resection can be obtained by dissecting posteriorly in a submucosal and subperiosteal plane until transoral removal of the tumour; some authors recommend keeping the tumour enveloped in a vasoconstrictor soaked gauze and gradually exposing it to work in a bloodless field 30 .…”

Section: Endoscopic Approachmentioning

confidence: 99%

Juvenile nasopharyngeal angiofibroma – literature review and case series

Vuzitas

Manea

2018

Romanian Journal of Rhinology

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Juvenile nasopharyngeal angiofibroma is a rare benign tumour of vascular origin found in adolescent males, originating around the sphenopalatine foramen. Although the exact pathogenesis of the tumour is not yet known, natural history and growth patterns can be predicted. JNA progressively involves the nasopharynx, nasal cavity, paranasal sinuses, pterygopalatine fossa, infratemporal fossa and, in severe cases, an orbital or intracranial extension can be seen. Early diagnosis based on clinical examination and imaging is mandatory to ensure the best resectability of the tumour, as small to moderate tumours can be managed exclusively endoscopically. Preoperative angiography can reveal the vascular sources and allow embolization to prevent significant bleeding. We present a brief literature review followed by our case series of endoscopic removal of 7 juvenile nasopharyngeal angiofibromas.

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Comparison between endoscopic and open surgery in 37 patients with nasopharyngeal angiofibroma

Cited by 11 publications

References 12 publications

Juvenile Nasopharyngeal Angiofibroma: A Case Report

Juvenile Nasopharyngeal Angiofibroma: A Case Report

Exclusive Endoscopic Resection of Juvenile Nasopharyngeal Angiofibroma: A Systematic Review of the Literature

Juvenile nasopharyngeal angiofibroma – literature review and case series

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