Postoperative follow-up of juvenile nasopharyngeal angiofibromas: assessment by CT scan and MR imaging

Abstract

The purpose of this study was to assess the radiological findings after surgical removal of juvenile nasopharyngeal angiofibromas (JNA). The postoperative CT and MRI scans of ten patients were reviewed. The cured group included six patients. The non-controlled group included six patients with eight recurrences. Two patients belonged to both groups as they were also followed and cured after surgery for relapse. Four recurrences were asymptomatic and diagnosed by imaging. The imaging patterns were matched to the patients clinical status and endoscopic findings. In the cured group, non-enhanced residual soft tissue masses were seen in all cases. In the non-controlled group, recurrence was always demonstrated on early postoperative CT or MR as a dramatically enhanced mass. The recurrence was located in the lateral or superior aspect of the nasopharynx (n = 3), deep to the fossa of Rosenmuller (n = 4) or out of the nasopharynx (n = 1). In two cases a remaining enhanced mass disappeared spontaneously on iterated examinations. Because of numerous asymptomatic relapses, a radiological workup is recommended four months after surgery, even in patients with normal endoscopy, to rule out posterolateral or extranasopharyngeal recurrences. Spontaneous evolution of residual masses must be appreciated on iterated imaging examinations.

Juvenile nasopharyngeal angiofibroma: Clinical factors associated with recurrence, and proposal of a staging system

“…Besides, so far, the recurrence concept has not been defined, although reports exist concerning the possible lack of significance of residual lesions observed in imaging studies without clinical expression, in follow-up [2,9,16]. We considered recurrence when clinical and imaging tumor suspicion translated into clinical symptoms and growth during follow-up.…”

“…Recurrence was defined as clinical or radiologic tumor presence in nasopharynx, nasal fossa, or neighboring structures, with confirmed growth accompanied by symptomatology including epistaxis, nasal obstruction, or facial deformity after 6 months of follow-up from the initial treatment [2,12,15,16].…”

Juvenile nasopharyngeal angiofibroma—our experience at a referral hospital

“…However, angiofi broma arising from the middle turbinate [9] and from the nasal septum [10] has been reported. Chagnaud et al [11] assessed the radiological fi ndings after the surgical removal of juvenile nasopharyngeal angiofi broma and found dramatically enhanced mass on early postoperative CT or MRI. The recurrence was located in the lateral or superior aspect of the nasopharynx deep to the fossa of Rosenmuller.…”

A rare complication of adenoidectomy: inflammatory nasopharyngeal polyp

“…Ancak özellikle ergen dönemdeki erkek çocuklarda görülen nazofarengeal kitlelerde anjiofibroma yönünden dikkatli olunmalı ve bu kitlelerden biyopsi alınacağı zaman kanama yönünden hazırlıklı olunmalıdır. [1,5] Antrokoanal polip, mukus retansiyon kistleri, Thornwaldt kisti gibi enflamatuar ve kistik nazofarenks kitleleriyle çocukluk döneminde sık karşıla-şılır. Çocukluk döneminde nazofarenksin malign tümör-leri ise daha nadirdir.…”