Juvenile Angiofibroma: Current Management Strategies

Safadi, Ahmad; Schreiber, Alberto; Fliss, Dan M.; Nicolai, Piero

doi:10.1055/s-0037-1615810

Cited by 32 publications

(41 citation statements)

References 56 publications

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“…Tumor extension into the posterior nasopharynx may obstruct the eustachian tube, resulting in conductive hearing loss. Extension into the orbital or ITF will result in proptosis and cranial nerve defects, mainly sensation loss along CN V2 distribution as exhibited by our patient 12,13 . Our patient's main complaint was left‐sided cheek numbness along CN V2 distribution and gum numbness most likely due to nerve injury from manipulation and dissection of extensive tumor spread in the PPF where the nerve naturally passes through 14…”

Section: Discussionmentioning

confidence: 73%

“…Extension into the orbital or ITF will result in proptosis and cranial nerve defects, mainly sensation loss along CN V2 distribution as exhibited by our patient. 12,13 Our patient's main complaint was left-sided cheek numbness along CN V2 distribution and gum numbness most likely due to nerve injury from manipulation and dissection of extensive tumor spread in the PPF where the nerve naturally passes through. 14 Predominantly located in the posterior nasopharynx, JNAs are observed having a predictable pattern of spread.…”

Section: Discussionmentioning

confidence: 90%

“…From this location, contiguous spread of the tumor is observed to continue in one of two pathways. The anterolateral spread is most commonly seen in more than 70% of reported cases 12 . As the tumor spreads to the PPF, it progresses anteriorly, displacing the posterior wall of the maxillary sinus.…”

Section: Discussionmentioning

confidence: 99%

“…Laterally, the tumor extends to the pterygoid fossa. These predictable patterns of spread greatly aid the surgeon during anticipatory surgical planning 12,15 …”

Section: Discussionmentioning

confidence: 99%

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Combined endoscopic and transoral resection of a high‐staged juvenile nasopharyngeal angiofibroma: A pictorial essay

et al. 2020

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Juvenile nasopharyngeal angiofibromas (JNAs) are highly vascular and benign tumors that can expand into the skull base. Delay of treatment can result in intracranial invasion, requiring extensive open approaches such as a facial translocation, maxillary swing, or an orbitozygomatic craniotomy. We describe a single-stage, combined endoscopic and transoral approach on a 14-year-old male with extensive high-stage dumbbell-shaped JNA involving the infratemporal fossa, orbit, buccal space, and intracranial extension into Meckel's cave. Successful resection of the tumor and good postoperative outcome was achieved. A transoral approach allowed for greater access to the infratemporal fossa, where endonasal resection was not possible, allowing for improved visualization, greater traction, and dissection. In select highly staged JNAs with significant lateral extension and intracranial involvement, successful and complete resection may be accomplished with this combined approach. Utilization of this approach avoids the morbidity of more invasive open approaches.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

“…Laterally, the tumor extends to the pterygoid fossa. These predictable patterns of spread greatly aid the surgeon during anticipatory surgical planning 12,15 …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Combined endoscopic and transoral resection of a high‐staged juvenile nasopharyngeal angiofibroma: A pictorial essay

et al. 2020

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“…It is recommended to perform embolization 24-48 hours before the planned surgery [21]. The most commonly used materials for this are: polyvinyl alcohol (PVA), microparticles, cyanoacrylate adhesives, as well as ethylene-vinyl alcohol Onyx [22].…”

Section: Diagnosticsmentioning

confidence: 99%

Juvenile angiofibroma: etiology, diagnosis, treatment

Madalena

Blicharz

Drozd

et al. 2020

J Educ Health Sport

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the tumor, depending on its location. Due to the vascularnature of the tumor, the basic preoperative procedure is tumor vessel embolization, which allows reducing blood loss during surgery. Conclusions: Juvenile angiofibroma shows some characteristic features-it occurs at a similar age, in one sex and in one localization in the organism. Due to the invasive tumor growth, the risk of bone destruction and relapse, the role of imaging tests is important, allowing the diagnosis of a tumor at an early stage of its development.

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Embolization of Internal Carotid Artery Branches in Juvenile Nasopharyngeal Angiofibroma

et al. 2020

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Objective Preoperative embolization of juvenile nasopharyngeal angiofibroma (JNA) is usually performed by the occlusion of branches of the external carotid artery (ECA). However, a significant proportion of JNAs also receive blood from the internal carotid artery (ICA). The objective of this study was to report on the feasibility and clinical impact of superselective embolization of ICA branches in complex cases of JNA. Methods This was a single‐center retrospective study of all patients operated on for JNA between 2000 and 2018. The patients treated with embolization of branches of the ICA were identified. The results in terms of complications, intraoperative blood loss, and rate of residual disease were analyzed and compared to those of a control group of patients treated only with embolization of ECA branches and matched by age, stage, angiographic pattern, surgical approach, and previous surgery. Results Ninety‐two patients were included. Embolization of branches of the ICA was attempted in 14 cases of advanced or recurrent tumors and was ultimately possible in nine cases. There were no complications after embolization. The mean intraoperative blood loss was 1428 mL. Residual disease was found in three cases (33%). There was no significant difference compared with the control group (mean intraoperative blood loss = 1355 mL, residual disease = 4 (44%); all P > .05). Conclusion In this retrospective study, we report the feasibility of superselective embolization of ICA branches in selected cases of JNA. There was no observed benefit of this technique in terms of intraoperative bleeding or decreased risk of residual disease. Level of Evidence 4 Laryngoscope, 131:E775–E780, 2021

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Juvenile Angiofibroma: Current Management Strategies

Cited by 32 publications

References 56 publications

Combined endoscopic and transoral resection of a high‐staged juvenile nasopharyngeal angiofibroma: A pictorial essay

Combined endoscopic and transoral resection of a high‐staged juvenile nasopharyngeal angiofibroma: A pictorial essay

Juvenile angiofibroma: etiology, diagnosis, treatment

Embolization of Internal Carotid Artery Branches in Juvenile Nasopharyngeal Angiofibroma

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