Endoscopic transnasal approach for nasopharyngeal angiofibroma without arterial embolism
10.3760/cma.j.issn.1673-0860.2014.01.013
- VernacularTitle:内镜经鼻入路治疗未行动脉栓塞的鼻咽血管纤维瘤
- Author:
Donghui YANG
1
;
Qianhui QIU
;
Minzhi LIANG
;
Xianggao TAN
;
Guangsheng XIA
Author Information
1. 525200,广东省高州市人民医院耳鼻咽喉科
- Keywords:
Angiofibroma;
Nasopharyngeal neoplasms;
Endoscopy;
Otorhinolaryngologic surgical procedures
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2014;49(1):54-57
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility of endoscopic resection without arterial embolism for nasopharyngeal angiofibroma and the strategy of decreasing the bleeding during the operation.Methods The clinical data of twenty-five cases of nasopharyngeal angiofibroma were retrospective analyzed,including 3 cases of Radowski stage Ⅱ a,5 cases of stage Ⅱ b,4 cases of stage Ⅱ c and with 13 cases of stage Ⅲ a.All cases did not receive the arterial embolism,and controlled hypotension were adopted under endoscopic transnasal approach during the tumor resection.Two cases were added the labiogingival incision.During the operation,under the opening vision,cutting out the outside of the infratemporal fossa,and the pterygoid process to adequate exposure the pterygopalatina fossa and infratemporal fossa.Early recognition of anatomical landmarks and establish the safety plane,along the periphery of the tumor to proceed with micro-separation,early blocking tumor nutrient vessels,en bloc resection of the tumor and some other ways to reduce bleeding and tumor resection.Results Amount of bleeding during operation was 600-1500 ml,none of them had internal carotid artery injury and intracranial injury or some other complication.Follow-up 2-3 years was available in all patients,except 1 case with residual of tumor surrounding the optic nerve,the other 24 cases had no residual tumor and relapses.Conclusions The preoperative occlusion and artery ligation may not be needed.Surgical technique is the key to reduce blood loss,and it is feasible to have endoscopic resection of nasopharyngeal angiofibroma with proper operating technique.
