Angiofibroma/surgery* ; Endoscopy ; Humans ; Nasopharyngeal Neoplasms/surgery* ; Retrospective Studies

Angiofibroma/surgery* ; Endoscopy ; Humans ; Nasopharyngeal Neoplasms/surgery* ; Nasopharynx ; Nose

Adolescent ; Angiofibroma ; surgery ; Endoscopy ; Humans ; Male ; Nasopharyngeal Neoplasms ; surgery ; Nose ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods

Angiofibroma/surgery* ; Epididymis/surgery* ; Genital Neoplasms, Male/surgery* ; Humans ; Immunohistochemistry ; Male ; Middle Aged

OBJECTIVE/strong: To describe a case of juvenile angiofibroma with unusual protrusion out of the nasal cavity, and its management with surgery and radiotherapy.br /br /strongMETHODS:/strong br /strongDesign/strong: Case Report br /strongSetting/strong: Tertiary Public Referral Centre br /strongPatient/strong: Onebr /br /strongRESULTS/strong: A 17-year-old gentleman presented with a huge tumor protruding from his left nostril, diagnosed with juvenile angiofibroma stage IlIA by MRI and angiography. Following successful pre-operative embolization, the protruding mass was ligated and truncated, followed by surgical resection via external approach. Post-operative residual tumor was treated with adjuvant radiotherapy. There was no evidence of recurrence after nine months.br /br /strongCONCLUSION/strong: A high index of suspicion is of paramount importance in the diagnosis of JA and avoids the possibility of an unwarranted biopsy which could spell disaster. The most useful tools for diagnosis are MRI and arterial angiography. Treatment is primarily surgical. Irradiation therapy has been reported to achieve satisfactory outcomes, especially for unresectable residual disease and/or intracranial extension, where total surgical resection is unlikely to be attained without unacceptable morbidity./p
Human ; Male ; Adolescent ; Angiofibroma-diagnosis, radiotherapy, surgery ; Nasopharyngeal Neoplasms ; neoplasms ; Magnetic Resonance Imaging ; Nasal Cavity ; nose

OBJECTIVETo investigate the efficacy and the surgical techniques of transnasal endoscopic procedure for juvenile nasopharyngeal angiofibroma (JNA).

METHODSTwenty-one nasopharyngeal angiofibroma patients were treated using transnasal endoscopic approach. They were divided into group A (without intracranial extension) and group B (minimal intracranial extension) according to the staging of Sessions. The patients were treated mostly with endoscopic surgery. In two midfacial operations cases, endoscopy was also used. The staging, average blood loss during surgery, tumor residual, and (or) recurrent tumor were evaluated.

RESULTSGroup A (19 cases) had an average blood loss of 1000 ml. Nineteen patients had no residual or recurrent tumor over a follow-up of 8-24 months. Group B (2 cases) had an average blood loss of 1500 ml. One of the patients had minimal residual tumor around the cavernous sinus, but showed no progression over a follow-up of 2 years. Another patient had no residual or recurrent tumor over a follow-up of 8 months.

CONCLUSIONSThe data suggests that transnasal endoscopic surgical techniques can be used to treat JNA which either limited to nasal and nasopharyngeal cavities or and the tumor with sphenoid and ethmoid invasions and even minimal intracranial extension.

Adolescent ; Adult ; Angiofibroma ; surgery ; Child ; Endoscopy ; methods ; Humans ; Male ; Nasopharyngeal Neoplasms ; surgery ; Nose ; surgery ; Retrospective Studies ; Young Adult

OBJECTIVE: To explore the feasibility of treatment on angiofibroma patients with stage III, IV by midfacial degloving approach and modified maxillectomy. METHOD: From Feb. 2001 to Aug. 2004, midfacial degloving approach and modified maxillectomy was used for treating 7 angiofibroma patients with stage III, IV. Using Fisch stage: Five cases were in stage III, 2 cases were stage IV; 2 cases with stage III accepted midfacial degloving approach and modified maxillectomy. Five cases accepted midfacial degloving approach and Le fort I approach (stage III, 3 cases; stage IV, 2 cases). One patient accepted the combined therapy of facial approach and cranium approach. 6 cases accept the embolization of the artery which feed the tumor (2 cases in stage IV, 4 cases in stage III). RESULT: The blood loss was (600 +/- 324) ml in operation, the blood loss in operation of patients with selective preoperative embolization was (483 +/- 165) ml. The blood loss of one case with no selective preoperative embolization was 1300 ml. The operating time was 129 +/- 22 min. The pathology of 7 cases was nasopharyngeal angiofibroma. For 30 to 72 months follow-up, No tumor recurrence were observed, one case in stage III accepted the selective preoperative embolization got the tumor recurrence 1 year after the surgery. After the second surgery, no tumor recurrence were seen till now. CONCLUSION For the patients in stage III, IV, midfacial degloving approach and modified maxillectomy is not only good for radical excision, curtating the operating time and blood loss, but also good for the cosmetic outlook and functional recovery. The selective preoperative embolization has a good significance on reducing the operating blood loss and tumor recurrence rate.
Adolescent ; Adult ; Angiofibroma ; pathology ; surgery ; Child ; Humans ; Male ; Maxilla ; surgery ; Nasopharyngeal Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Retrospective Studies ; Young Adult

OBJECTIVETo evaluate the feasibility of endoscopic surgery using the low-temperature plasma radiofrequency for nasopharyngeal angiofibroma (NA).

METHODSThe clinical data of 4 patients treated between December 2005 and August 2009 were retrospectively analyzed. The tumor in one patient was at stage I and three patients were at stage II, all these patients were treated by endoscopic surgery using the low-temperature plasma radiofrequency under controlled hypotension anesthesia. Preoperative angiography and embolisation were underwent in all patients. Bipolar coagulation was used to help hemostasis during operation.

RESULTSThe tumor in all 4 patients was completely removed. The operation time was 60, 80, 110, 90 min respectively. The blood loss was 250, 250, 320, 280 ml respectively. Neither blood transfusion nor complications were encountered perioperatively. Follow-up ranged from 6 months to 4 years, none of the patients recurred.

CONCLUSIONSEndoscopic surgery using low-temperature plasma radiofrequency for nasopharyngeal angiofibroma has many advantages such as less bleeding and total tumor removal. It is a minimally invasive surgical method for nasopharyngeal angiofibroma.

Adolescent ; Adult ; Angiofibroma ; surgery ; Catheter Ablation ; methods ; Endoscopy ; Humans ; Hypothermia, Induced ; Male ; Nasopharyngeal Neoplasms ; surgery ; Retrospective Studies

OBJECTIVETo explore the feasibility of endoscopic resection without arterial embolism for nasopharyngeal angiofibroma and the strategy of decreasing the bleeding during the operation.

METHODSThe clinical data of twenty-five cases of nasopharyngeal angiofibroma were retrospective analyzed, including 3 cases of Radowski stageIIa, 5 cases of stageIIb, 4 cases of stageIIc and with 13 cases of stage IIIa. 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 pterygopalatine 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.

RESULTSAmount 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.

CONCLUSIONSThe 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.

Adolescent ; Adult ; Angiofibroma ; surgery ; Endoscopy ; Humans ; Male ; Nasal Surgical Procedures ; methods ; Nasopharyngeal Neoplasms ; surgery ; Retrospective Studies ; Young Adult

OBJECTIVETo explore the optical surgical approaches for the resection of early and advanced stage of nasopharyngeal angiofibromas.

METHODSTwenty two male patients aged 9 - 30 years (median 16 years) hospitalized in Xiangya Hospital from June 2003 to July 2006 with nasopharyngeal angiofibroma were recruited. Five operative approaches were selected according classification of juvenile nasopharyngeal angiofibroma described by Fisch. Six cases with stage I nasopharyngeal angiofibroma underwent endoscopic transnasal surgery. Six cases with stage II and 2 cases with stage III underwent endoscopic endonasal middle meatal transmaxillary-antrum approach. Three cases with stage III and 2 cases with stage IV underwent endoscopic endonasal middle and inferior meatal approach with extended transmaxillary-antrum resection. One case with stage IV underwent microscopic preauricula infratemporal fossa approaches combined with endoscopic endonasal middle and inferior meatal transantral approach. Two cases with stage IV underwent nasomaxillary osteotomy approach.

RESULTSAfter surgery, CT scan or MR image showed that total removal of the tumor was achieved in 21 patients. One patient who received subtotal resection were performed by second endoscopic surgery and obtained total resection. No postoperative complications have been encountered in all treated patients. Nine months to 3 years follow up indicated that no cases recurred after surgery.

CONCLUSIONSAppropriate surgical approach should be selected according to the clinical classification and whether the tumor has extended into whole nasal cavity, lateral fossa infratemporalis, intracranial or not. Such approaches might better facilitate the complete removal of nasopharyngeal angiofibromas and reduce the surgery-related injury.

Adolescent ; Adult ; Angiofibroma ; pathology ; surgery ; Child ; Endoscopy ; Humans ; Male ; Nasopharyngeal Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Young Adult