Juvenile angiofibroma: A review of the literature and a case series report

To approach Juvenile nasopharyngeal angiofibroma extending to the sphenoid sinus, pterygoid wedge and minimal involvement of the pterygopalatine fossa (Radkowski Stage 2 A) with an endoscopic technique without embolization with no recurrence and minimal morbidity and mortality. This is a retrospective, descriptive study based on the medical records of 15 patients with histologically confirmed JNA who underwent endoscopic binostril four handed endoscopic excision in our centre without embolisation between 2010 and 2015. All 15 patients were young males with a mean age of 14.13 years who underwent endoscopic excision of JNA without embolisation. Nasal obstruction (100 %) and epistaxis (100 %) were the most common symptoms. Average surgery length was 1 h 41 min. Mean blood loss was 67.2 ml and none of patients required blood transfusion. All patients had crusting and septal defect postoperatively, only 3 (20 %) had synechiae. Mean hospitalization time was 3.66 days. 2 (13.33 %) of our patients had a residual tumor and one (6.66 %) had a relapse in pterygoid wedge. There were no cases of death or significant morbidity. The follow up period was 1 year. Endoscopic endo nasal bi nostril four handed technique can achieve complete resection without embolization in case of small to medium sized JNA s in the hands of an experienced surgeon with minimal blood loss, low rates of recurrence and morbidity.

“…Mean hospitalization time was 3.56 ± 0.6 days [20]. JNA is a vascular tumor dreaded and infamous for its high recurrence rates ranging from 25 to 46 % [20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Excision of Non-embolized Juvenile Nasopharyngeal Angiofibroma: Our Technique

Janakiram¹,

Sharma²,

Panicker³

2016

“…It is highly vascular, uncapsulated and locally invasive tumor. Its incidence has been cited to be 0.05 % of all head and neck neoplasms as per many study reports [1]. In recent times there has been a major change in its epidemiology, pathogenesis, diagnosis, medical management, pre-operative care, surgical management and post-operative care including radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Juvenile Nasopharyngeal Angiofibroma: A Rise in Incidence

Tiwari

Teron

Saikia

et al. 2015

Juvenile nasopharyngeal angiofibroma is a very rare, highly vascular, uncapsulated and locally invasive tumor. Recently a changing trend has been seen in its epidemiology, pathogenesis, diagnosis, medical management, pre-operative care, surgical management and postoperative care including radiotherapy. Study the changing trend basically in the north-eastern region of south-east Asia and its prospects. Retrospective study of patients presenting with JNA between the study period of 6 months (October 2014-March 2015 in the, Department of Otolaryngology and Head and Neck Surgery, Assam Medical College, Dibrugarh, Assam, India. Incidence in comparison to previous studies has increased. Eight patients were treated in the study period. Different approaches were used. Mean age of presentation was 18 years and more than 75 % of them were either Stage III or Stage IV. Different approaches like transpalatine, transpalatine along with transnasal, lateral rhinotomy and endoscopic surgery were used. The recurrence rate was 12.5 %. Surgery by transpalatine approach should be the choice of treatment. Endoscopic resection should be only used for Stage I or Stage II disease.

“…Nasopharyngeal angiofibroma (NA) is a rare tumor that comprises only 0.5% of neoplasms in the head and neck [1][2][3]. It is pathognomonically characterized as a benign vascular tumor located in the posterior nasopharynx of adolescent males.…”

Section: Introductionmentioning

confidence: 99%

Nasopharyngeal Angiofibroma: Paradigm Shift in Management

Latoo

Hamid

Jallu

et al. 2017

To report on a series of patients of nasopharyngeal angiofibroma of varied ages with different stages and management algorithm which reduced morbidity associated with this tumour. Retrospective. We report a series of ten patients who presented to a tertiary care institution and were diagnosed to have NA from 2012 to 2014. Patients were categorized by Radkowski staging and data was collected to document differences in terms of presentation, operative technique, and postoperative course. All patients underwent preoperative embolization. Stage I and selected stage II lesions were approached endoscopically while the remainder underwent open resection. In comparison with open procedures, endoscopic procedures had less intraoperative blood loss (350 vs. 630 cc), operative time (90 vs. 150 min) and the average hospital stay was one day less (3 vs. 4 days). Proper preoperative work up including nonsurgical intervention in the form of embolisation and selecting proper surgical approach is rewarding in case of angiofibromas of all stages which help to reduce morbidity associated with these benign tumours.