Juvenile nasopharyngeal angiofibroma:endoscopic surgery and follow-up results
10.3760/cma.j.issn.1673-0860.2010.03.002
- VernacularTitle:鼻内镜下鼻咽血管纤维瘤切除术及疗效随访
- 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
1. 首都医科大学附属北京同仁医院
- Keywords:
Nasopharyngeal neoplasms;
Angiofibroma;
Endoscopy;
Neoplasm recurrence,local;
Prognosis
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2010;45(3):180-185
- CountryChina
- Language:Chinese
-
Abstract:
Objective To present the changes of surgical approaches for the resection of juvenile nasopharyngeal angiofibromas(JNA)and the follow-up results.Methods The 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(RadkowskiⅠa-Ⅱb)and Group B(Radkowsik Ⅱc-Ⅲb).The tumor stages,feeding vessels,operating time,complications and recurrence were observed and recorded.Results There were 7 patients with stageⅠa,3 patients with stageⅠb,5 patients with stage Ⅱ a,6 patients with stage Ⅱ b,4 patients with stage Ⅱc,23 patients with stage Ⅲa,11 patients with stage Ⅲb.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 difierence 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).Conclusions The 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(Radkowski Ⅰ a-Ⅱ b)have a low morbidity.JNA at Radkowski stage Ⅱ c and above have residual and recurrent risk.
