Juvenile nasopharyngeal angiofibroma stages I and II: A comparative study of surgical approaches

Yiotakis, Ioannis; Eleftheriadou, Anna; Davilis, D.; Giotakis, Evangelos; Ferekidou, Eliza; Korres, Stavros; Kandiloros, Dimitrios

doi:10.1016/j.ijporl.2008.02.007

Cited by 42 publications

(39 citation statements)

References 19 publications

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“…The main advantage of endoscopic surgery is the possibility of obtaining a broad view of the lesion and its anatomic relationship with adjacent structures, promoting more accurate, complete dissection and better control of bleeding [9][10][11]. Other advantages include less surgical time, hospitalization, absence of visible scars, avoids complication such as epiphora, dysesthesia, trismus, and craniofacial deformities [10,[12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Juvenile Nasopharyngeal Angiofibroma: A Rise in Incidence

Tiwari

Teron

Saikia

et al. 2015

Indian J Otolaryngol Head Neck Surg

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Juvenile nasopharyngeal angiofibroma is a very rare, highly vascular, uncapsulated and locally invasive tumor. Recently a changing trend has been seen in its epidemiology, pathogenesis, diagnosis, medical management, pre-operative care, surgical management and postoperative care including radiotherapy. Study the changing trend basically in the north-eastern region of south-east Asia and its prospects. Retrospective study of patients presenting with JNA between the study period of 6 months (October 2014-March 2015 in the, Department of Otolaryngology and Head and Neck Surgery, Assam Medical College, Dibrugarh, Assam, India. Incidence in comparison to previous studies has increased. Eight patients were treated in the study period. Different approaches were used. Mean age of presentation was 18 years and more than 75 % of them were either Stage III or Stage IV. Different approaches like transpalatine, transpalatine along with transnasal, lateral rhinotomy and endoscopic surgery were used. The recurrence rate was 12.5 %. Surgery by transpalatine approach should be the choice of treatment. Endoscopic resection should be only used for Stage I or Stage II disease.

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Section: Discussionmentioning

confidence: 99%

Juvenile Nasopharyngeal Angiofibroma: A Rise in Incidence

Tiwari

Teron

Saikia

et al. 2015

Indian J Otolaryngol Head Neck Surg

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“…Surgery aims at a complete and safe resection of tumour, with minimal morbidity and loss of blood. Transpalatal, transmaxillar (lateral rhinotomy or midfacial degloving), Le Fort 1 osteotomy and infratemporal fossa approaches [2,9,12,13] used to be the traditional surgical methods commonly used to remove JNA. Recent reports recommend endoscopic surgery [4,11,[16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…It is agreed that surgical excision is the treatment of choice for JNA [2,5,9,11]. Traditionally, surgical approaches used to resect JNA, have been transpalatal, transmaxillar (lateral rhinotomy or midfacial degloving), Le Fort 1 osteotomy, and infratemporal fossa craniotomy approaches [2,9,12,13]. Preoperative selective embolisation of feeding arteries has decreased intraoperative haemorrhage and made it possible to resect even the largest tumours.…”

Section: Introductionmentioning

confidence: 99%

The changing surgical management of juvenile nasopharyngeal angiofibroma

Renkonen

Hagström

Vuola

et al. 2010

Eur Arch Otorhinolaryngol

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The management of juvenile nasopharyngeal angiofibroma (JNA) has changed during the last decades but it still continues to be a challenge for the multidisciplinary head and neck surgical team. The aim of this study was to review the used treatment approach and outcome of JNA in a single institution series of 27 patients diagnosed and treated during the years 1970-2009. All patients were male, with the median age of 17 years (range 11-33 years). Surgery was used as the primary treatment in every case. Surgical approaches varied, transpalatal approach (N = 14) being the most common approach used in this series. During the last decade various other techniques were applied, including endoscopic (N = 3) resection. Two patients were additionally treated with antiangiogenic agents and one patient with stereotactic radiotherapy. The primary recurrence rate was 37% and it seemed to correlate with vascular density of tumour and the surgical approach used. We suggest that the management of JNA should be planned by an experienced head and neck surgeon, as part of a multidisciplinary team, preferably in a tertiary referral setting, and the recent development of the available therapies should be taken into account to minimise the risk of recurrence.

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“…CT was and is essential in determining the precise location of the tumor (Fig. 2) [15]. Now MRI with and without gadolinium is the initial diagnostic method of choice.…”

Section: Radiological Evaluation Of Jnamentioning

confidence: 99%

“…In the radiological evaluation of JNA, intracranial extension is usually extraduraldestroying bone at the skull base, extending adjacent to the dura, but rarely invading the dura [16]. [15] Angiography and embolization of JNA If a patient is a surgical candidate, preoperative carotid angiography is in order for the complete blood supply of the tumor to be demarcated (Fig. 4).…”

Section: Radiological Evaluation Of Jnamentioning

confidence: 99%