Experiência de sete anos em pacientes com angiofibroma nasofaríngeo juvenil

Gaillard, A; Anastácio, Vanessa Menegatti; Piatto, Vânia Belintani; Maníglia, José Victor; Molina, Fernando Drimel

doi:10.1590/s1808-86942010000200016

Cited by 32 publications

(8 citation statements)

References 31 publications

(69 reference statements)

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“…In the present study most of the patients (92%) belonged to age group of 11-20 years. Almost similar data was published in by Lara et al 16 Our study showed that all the patients were male. Genetic studies have demonstrated a close relation between JNA and androgen receptor expression, suggesting that this tumor is androgen dependent.…”

Section: Discussionsupporting

confidence: 89%

Current trend of surgery in juvenile nasopharyngeal angiofibroma: a hospital based retro-prospective study

Jain

Kumar

Singh

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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Background: The aim of the present study was to know the current trends of surgery, to determine the surgery of choice according to stage and complications, rate of recurrence of following surgery.Methods: Retro-prospective study was carried out from August 2004 to July 2014, in which 31 prospective and 8 prospective cases were included. All the details of patients like general examination, ENT examination, computed tomography or magnetic resonance imaging scan finding, staging, and approach of surgery, complications, and recurrence rate were recorded. Results: In our study all the patients were male and the mean age was 15.74 years (age ranged 11 to 22 years). Most frequent sign and symptoms were epistaxis (92.4%), nasal blockage (90%), and facial swelling (18%). Most common surgical approach was ‘trans palatine approach’ (51% cases) belongs to stage IIa, IIb, IIc, IIIa, IIIb and ‘lateral rhinotomy approach’ used in 35% cases. And by endoscopic approach (only 5.1% cases) were operated due to lack of embolization technique. Overall recurrence was about 29% (66% cases belonged to stage III). Postoperative complications were septal perforation 33%, palatal perforation 9.5%, facial disfiguration 9.5% and 9.5% hypertrophic scar.Conclusions: Our study we concluded that, 92% of patients age group 11 to 20 years and all were males. Epistaxis and nasal obstruction were the most common symptoms. Most of the recurrent tumor belonged to stage III tumor. Most appropriate surgical approach for stage I, IIa and IIb was transpalatine approach and for stage IIc and IIIa was lateral rhinotomy. Complete excision of intracranial extension of tumor was difficult and causes recurrence of diseases.

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Section: Discussionsupporting

confidence: 89%

Current trend of surgery in juvenile nasopharyngeal angiofibroma: a hospital based retro-prospective study

Jain

Kumar

Singh

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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“…of patients No. of Patients < 10 years Age (years) Sex Follow-up Gaillard [ 40 ] R 16 1 9 M 7 yrs Kalani [ 8 ] R 22 1 9 M 1 mo Ardehali [ 5 ] R 47 1 7 M 2.5 yrs Ferreira [ 39 ] P 9 1 9 M 1 yr Handa [ 22 ] C 1 1 8 M 6 mo Baptista [ 38 ] C 1 1 8 F 6 mo Salcone [ 37 ] C 1 1 9 M 6 mo Gupta [ 23 ] CS 8 2 1: 4 2: 6 …”

Section: Resultsmentioning

confidence: 99%

Early-Onset Juvenile Nasopharyngeal Angiofibroma (JNA): A Systematic Review

Newman,

Nguyen,

McHugh

et al. 2023

Journal of Otolaryngology - Head & Neck Surgery

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Background Juvenile Nasopharyngeal Angiofibroma (JNA) is a fibrovascular tumor of the nasopharynx that classically presents in adolescent males. The reported mean age of onset is between 13 and 22 years old [1–6]. Significant androgen stimulation is hypothesized to explain the strong predisposition for JNA to present in young adolescent males. However, considerable variability in age at diagnosis exists with rare involvement of very young patients incongruent with typical male pubertal growth patterns. Objective The purpose of this systematic review is to identify cases of early-onset JNA (EOJNA), (defined as age < 10 years) in the literature and to examine the disease characteristics and treatments used in this patient group. A case of a 7 year old boy with EOJNA at our institution is also described and presented. Methods We searched Embase, Cochrane database and MEDLINE from 1996 to February 2021 for studies that reported cases of EOJNA. Relevant clinico-demographic data, disease severity and treatment outcomes were recorded and analyzed using descriptive statistics. We compared our findings with reported means for JNA in all ages. Results We identified 29 studies containing a total of 34 cases of EOJNA. The vast majority (31/34) of patients were males and the mean age of diagnosis was 8.15 years old. The most common presenting symptoms were nasal obstruction (65.2%) and epistaxis (60.9%). Patients were most commonly Radkowski stage II (39.4%) and III (39.4%). Primary treatment modalities included open surgery (66.7%), endoscopic surgery (24.2%), and radiotherapy (9.1%). Recurrence was evident in 30%. Radkowski stage and type of treatment did not differ significantly within the EOJNA group (p = 0.440 and p = 0.659, respectively). Conclusion This systematic review suggests that rare cases of EOJNA have distinct disease characteristics. Patients in this cohort appeared to have more advanced disease and higher recurrence rates when compared with reported averages. We hope that this review prompts increased clinical awareness of this potentially more aggressive subtype of JNA. As more cases of EOJNA are reported, a more powered statistical analysis of this cohort would be feasible.

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“…As occurrences in young adults from 14 to 25 years have been reported in the literature, the terminology “juvenile” exclusively for JNA is deemed to be a misnomer. Females can also be rarely affected [ 2 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Erosion of the superior orbital fissure involving the third and sixth nerves may produce diplopia. And intraorbital extension may produce proptosis [ 4 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Genetic studies have demonstrated a close relation between JNA and androgen receptor expression, signifying JNAs to be androgen-dependent, which in turn explains the male predominance of this set of particular tumors [ 4 , 8 ]. Another gene, the GSTM 1 gene, has also been implicated in the development of JNA where loss of expression of the GSTM 1 is found in these lesions [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Extended Endonasal Endoscopic (EEE) Surgery with Almost No Use of Adjuvant Radiotherapy for Juvenile Nasopharyngeal Angiofibroma (JNA)

Alam,

Chaurasia,

Farazi

et al. 2023

Medicina

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Background and Objectives: Juvenile nasopharyngeal angiofibroma (JNA) is an angiomatous hamartoma of the nasal cavity. It is a benign but locally aggressive vascular tumor of the nasopharynx affecting adolescent males. Many surgical procedures are in practice, but the extended endonasal endoscopic (EEE) approach for JNAs is a suitable and effective technique. Materials and Methods: Fifteen adolescent patients having JNA who underwent extended endonasal endoscopic (EEE) surgery from January 2010 to January 2022 were studied retrospectively. Patients having residual and recurrent JNAs and those who underwent surgery other than EEE were excluded. Results: The average age of the patients was 18.3 years of age. A total of six patients (40%) each had stage V and IV while three patients (20%) had stage III JNAs. Gross total removal was achieved in eight (53.3%) patients and seven (43.7%) had partial removal. There was no per or postoperative mortality. All the patients had at least 3 years of postoperative follow-up and during follow-ups, seven patients were found to have residual tumors, and two had recurrences. Discussion: During the last decades, the endoscopic approach for the resection of JNAs has gained increasing popularity due to its obvious advantages over transfacial approaches. The magnified and angled field of view “behind the corner” helping in a more complete inspection for the resection and shorter hospitalization time makes it a better choice than the other approaches. Conclusions: Endoscopy is an excellent approach for primary JNA. It allows well visualization and precise removal of the angiofibroma. An endoscopic multiangle, multicorridor skull base approach including Denker’s anteromedial maxillotomy is suitable and preferable for the resection of extensive JNAs.

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Experiência de sete anos em pacientes com angiofibroma nasofaríngeo juvenil

Cited by 32 publications

References 31 publications

Current trend of surgery in juvenile nasopharyngeal angiofibroma: a hospital based retro-prospective study

Current trend of surgery in juvenile nasopharyngeal angiofibroma: a hospital based retro-prospective study

Early-Onset Juvenile Nasopharyngeal Angiofibroma (JNA): A Systematic Review

Extended Endonasal Endoscopic (EEE) Surgery with Almost No Use of Adjuvant Radiotherapy for Juvenile Nasopharyngeal Angiofibroma (JNA)

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