Advanced craniofacial juvenile nasopharyngeal angiofibroma. Description of surgical series, case report, and review of literature

Abstract

Surgical treatment is the basic tactics in management of extensive JNA including endovascular embolization and resection of the tumor. We recommend using orbitozygomatic approach or its modifications in JNA. Radiation therapy may be recommended for patients with small residual tumor.

Atypical angiofibroma in a patient with compromised general health: A case report

“…Imaging examinations have aided the clinical diagnosis of NA, whereas computed tomography assists in diagnosing bone changes, magnetic resonance imaging evaluates the tumor extension to soft tissues, and angiography estimates the vascular content of the lesion and arterial supply [ 5 , 7 , 9 , 13 ]. However, many services have limited resources and, in our case, only computed tomography was performed.…”

“…Different classification methods for NA based on clinical and radiographic findings have been proposed to help defining the surgical approach [ 10 ]. The basic treatment for NA is surgical resection, but for cases in which the tumor is surgically inaccessible, radiation therapy has been recommended [ 5 , 13 ]. In addition, cases of extensive NA have been associated with morbidity and mortality [ 14 ].…”

Juvenile Nasopharyngeal Angiofibroma

“…• Radiation-induced malignancies Recent studies using radiation therapy as the definitive treatment of advanced JNAs have demonstrated impressive local control rates, varying from 78-85 %; however, significant side effects were also reported, making radiation a nonviable therapy in most cases [16,36]. Recurrence rate among patients who underwent isolated radiation therapy were 20-33 %.…”

“…Facial swelling, proptosis, headache, visual disturbance, and cranial nerve palsies may be signs of advanced disease [14,15]. Rare presenting symptoms include hyponasal speech, hyposmia, hearing loss, dacrocystitis, and palatal swelling or deformity [16]. Patients with intracranial extension, secondary to tumor extension through the roof of the infratemporal fossa or via the superior orbital fissure with extension into the cavernous sinus, may present with the classic signs of superior orbital fissure syndrome, ptosis, paralysis of extraocular muscles, and exophthalmos.…”

Craniofacial tumors blood supply

“…Краниофациальные опухоли (КФО) -гетерогенная группа новообразований, объединенных по топографическому принципу, имеющих различную гистологическую структуру и степень васкуляризации. Например, менингиомы, ювенильные краниофациальные ангиофибромы, капиллярные гемангиомы и некоторые злокачественные опухоли относятся к интенсивно кровоснабжаемым, а хондроидные опухоли и хордомы -к гиповаскулярным новообразованиям [1][2][3][4]. Вследствие распространения в различные анатомические регионы краниофациальные опухоли обычно получают кровоснабжение из нескольких артериальных систем, а их удаление зачастую сопровождается обильной кровопотерей.…”