Critical Look at the Surgical Approaches of Nasopharyngeal Angiofibroma Excision and “Total Maxillary Swing” as a Possible Alternative

Dubey, Siba P.; Molumi, Charles P.

doi:10.1177/000348940711601003

Cited by 13 publications

(10 citation statements)

References 27 publications

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“…However, it has obvious limitations. If lateral tumour growth to pterygopalatine and infratemporal fossae occurs, [25] it leads to higher risk of recurrence. In accordance with earlier reports, in our series the transpalatal approach was associated with a signiWcant risk of persistent disease and with more than one re-surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with earlier reports, in our series the transpalatal approach was associated with a signiWcant risk of persistent disease and with more than one re-surgery. The most common complication among patients treated with transpalatal approach is palatal Wstula, which usually tends to heal spontaneously [2,25]. Poor exposure for large tumours and the reported elevated rates of recurrence by us and others [8], make this approach less favourable in our armamentarium for JNA surgery.…”

Section: Discussionmentioning

confidence: 99%

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The changing surgical management of juvenile nasopharyngeal angiofibroma

Renkonen

Hagström

Vuola

et al. 2010

Eur Arch Otorhinolaryngol

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The management of juvenile nasopharyngeal angiofibroma (JNA) has changed during the last decades but it still continues to be a challenge for the multidisciplinary head and neck surgical team. The aim of this study was to review the used treatment approach and outcome of JNA in a single institution series of 27 patients diagnosed and treated during the years 1970-2009. All patients were male, with the median age of 17 years (range 11-33 years). Surgery was used as the primary treatment in every case. Surgical approaches varied, transpalatal approach (N = 14) being the most common approach used in this series. During the last decade various other techniques were applied, including endoscopic (N = 3) resection. Two patients were additionally treated with antiangiogenic agents and one patient with stereotactic radiotherapy. The primary recurrence rate was 37% and it seemed to correlate with vascular density of tumour and the surgical approach used. We suggest that the management of JNA should be planned by an experienced head and neck surgeon, as part of a multidisciplinary team, preferably in a tertiary referral setting, and the recent development of the available therapies should be taken into account to minimise the risk of recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The changing surgical management of juvenile nasopharyngeal angiofibroma

Renkonen

Hagström

Vuola

et al. 2010

Eur Arch Otorhinolaryngol

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“…Our team has experience of training and supervising non-mental health professionals in psychosocial interventions [23] and has already evolved materials and methods, which were further refined for this staff and patient group. These materials are now being trialled in the randomised trial, as detailed below.…”

Section: Methodsmentioning

confidence: 99%

“…CBT can be delivered by suitably trained non-psychotherapist staff [22,23], but to the best of our knowledge, this approach has not been attempted in a RCT in this context previously. In addition, only group interventions have been studied so far, with therapy delivered on a one-to-one basis yet to be tested in a fear of falling cognitive behavioural intervention study.…”

Section: Introductionmentioning

confidence: 99%

The STRIDE (Strategies to Increase confidence, InDependence and Energy) study: cognitive behavioural therapy-based intervention to reduce fear of falling in older fallers living in the community - study protocol for a randomised controlled trial

Parry

Deary

Finch

et al. 2014

Trials

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BackgroundAround 30% to 62% of older individuals fall each year, with adverse consequences of falls being by no means limited to physical injury and escalating levels of dependence. Many older individuals suffer from a variety of adverse psychosocial difficulties related to falling including fear, anxiety, loss of confidence and subsequent increasing activity avoidance, social isolation and frailty. Such ‘fear of falling’ is common and disabling, but definitive studies examining the effective management of the syndrome are lacking. Cognitive behavioural therapy has been trialed with some success in a group setting, but there is no adequately powered randomised controlled study of an individually based cognitive behavioural therapy intervention, and none using non-mental health professionals to deliver the intervention.Methods/DesignWe are conducting a two-phase study examining the role of individual cognitive behavioural therapy delivered by healthcare assistants in improving fear of falling in older adults. In Phase I, the intervention was developed and taught to healthcare assistants, while Phase II is the pragmatic randomised controlled study examining the efficacy of the intervention in improving fear of falling in community-dwelling elders attending falls services. A qualitative process evaluation study informed by Normalization Process Theory is being conducted throughout to examine the potential promoters and inhibitors of introducing such an intervention into routine clinical practice, while a health economic sub-study running alongside the trial is examining the costs and benefits of such an approach to the wider health economy.Trial registrationCurrent Controlled Trials ISRCTN78396615

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“…10 15 As open approach gives wider exposure, chances of recurrence are least and using endoscope in open approach enhances utility of both the concepts. 13,15 Risk of recurrence increases with invasion into vidian canal and sphenoid bone. Drilling sphenoid, pterygoid plates and the clivus to minimize recurrence treats invasion of tumor into cancellous bone of sphenoid.…”

Section: Treatment Optionsmentioning

confidence: 99%

Removal of Angiofibroma with Maxillary and Mandibular Swing: A Clinical Report

Ghorpade¹,

Deo²,

Thorat³

et al. 2012

An International Journal of Otorhinolaryngology Clinics

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Juvenile nasopharyngeal angiofibroma is vascular tumor found in adolescent males. With development of endoscopic fraternity, tumor can be addressed successfully with endoscopic approach; but one needs maximum exposure for large angiofibroma with local infiltration around. Maxillary and mandibular swing technique for removal of the tumor gives excellent exposure and good control on vascularity of the tumor.Postoperative follow-up for 1 year has shown minimal visible scar, cosmetic deformity in the patient.

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Critical Look at the Surgical Approaches of Nasopharyngeal Angiofibroma Excision and “Total Maxillary Swing” as a Possible Alternative

Abstract: We found total maxillary swing to be a relatively safe alternate approach for the resection of NPA. We removed the entire tumors in a wider surgical field under the microscope with reduced blood loss and minimal complications or chance of recurrences.

Cited by 13 publications

References 27 publications

The changing surgical management of juvenile nasopharyngeal angiofibroma

The changing surgical management of juvenile nasopharyngeal angiofibroma

The STRIDE (Strategies to Increase confidence, InDependence and Energy) study: cognitive behavioural therapy-based intervention to reduce fear of falling in older fallers living in the community - study protocol for a randomised controlled trial

Removal of Angiofibroma with Maxillary and Mandibular Swing: A Clinical Report

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