Juvenile nasopharyngeal angiofibroma: endoscopic surgery and follow-up results.
- Author:
Bing ZHOU
1
;
Ting CAI
;
Qian HUANG
;
Xi-hong LIANG
;
Xin NI
;
Yong-xiang WEI
;
Shun-jiu CUI
;
Luo ZHANG
;
Tong WANG
;
Hua-chao LIU
;
Ming LIU
;
De-min HAN
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Angiofibroma; pathology; surgery; Child; Endoscopy; Follow-Up Studies; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; pathology; surgery; Neoplasm Recurrence, Local; Retrospective Studies; Treatment Outcome; Young Adult
- From: Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2010;45(3):180-185
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo present the changes of surgical approaches for the resection of juvenile nasopharyngeal angiofibromas (JNA) and the follow-up results.
METHODSThe clinical records of 59 patients with JNA treated under endoscope between 2002 and 2009 were reviewed retrospectively. The patients were divided into two groups: Group A (Radkowski I a-II b) and Group B (Radkowsik II c-III b). The tumor stages, feeding vessels, operating time, complications and recurrence were observed and recorded.
RESULTSThere were 7 patients with stage I a, 3 patients with stage I b, 5 patients with stage II a, 6 patients with stage II b, 4 patients with stage II c, 23 patients with stage III a, 11 patients with stage III b. The average age at diagnosis in Group A (21 cases) was 23.9 years old. The average operating time was (106.0 +/- 43.7) min. The follow-up ranged from 3 months to 74 months (median 36 months) except for 3 missing cases. The average age at diagnosis in Group B (38 cases) was 16.2 years old and the average operating time was (152.9 +/- 58.0) min. The follow-up ranged from 3 months to 87 months (median 25 months) except for 5 missing cases. During follow-up, 6 patients in group B recurred. Infarction of thalamencephalon happened in 1 patient in group B who recovered totally afterwards. The difference in operating time between two groups was statistically significant (t = -3.232, P = 0.002). The life table was used to evaluate the survival curves and Log-rank test showed that the difference of recurrent time between two groups was statistically significant (P = 0.03).
CONCLUSIONSThe key techniques to remove tumor are bleeding control, drilling-out the bone that tumor invaded. Transpterygoid or posterolateral wall of maxillary sinus approach are recommended for tumors that extend to infratemporal fossa. Small and intermediate-sized JNA which have no deep invasion of skull base (RadkowskiIa-II b) have a low morbidity. JNA at Radkowski stage IIc and above have residual and recurrent risk.