Surgical Treatment of Non-embolized Patients with Nasoangiofibroma

Fonseca, Adriano Santana; Vinhaes, Eriko; Boaventura, Viviane; Andrade, Nilvano Alves de; Dias, Lislane Andrade; Medeiros, Vyrna; Coifman, Fernando

doi:10.1016/s1808-8694(15)30607-8

Cited by 21 publications

(23 citation statements)

References 24 publications

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“…Petruson et al did not encounter statistically significant differences between intraoperative bleeding in embolized and nonembolized patients [14,16] and found higher JNA relapse rates among embolized patients. Mc Combe et al suggested that preoperative embolization may compromise the identification of surgical margins as it reduces tumor size, consequently increasing chances of relapse [14,17]. Embolization can lead to difficulty in achieving plane of dissection by increasing the fibrous component of the tumor [18].…”

Section: Discussionmentioning

confidence: 93%

“…Many studies have stated the benefits of preoperative arterial embolization in controlling as much as 50 % of intraoperative bleeding and reduced complications when associated with the endoscopic approach alone [1,[10][11][12][13][14]. However, Preoperative embolization can be avoided in small tumors in contrary to the common belief that it is indispensable.…”

Section: Discussionmentioning

confidence: 99%

“…However, Preoperative embolization can be avoided in small tumors in contrary to the common belief that it is indispensable. Moulin et al concluded that embolization should only be offered to patients with larger tumors as a routine preoperative procedure after comparing the blood losses of embolized and non-embolized patients [14,15]. Petruson et al did not encounter statistically significant differences between intraoperative bleeding in embolized and nonembolized patients [14,16] and found higher JNA relapse rates among embolized patients.…”

Section: Discussionmentioning

confidence: 99%

“…Moulin et al concluded that embolization should only be offered to patients with larger tumors as a routine preoperative procedure after comparing the blood losses of embolized and non-embolized patients [14,15]. Petruson et al did not encounter statistically significant differences between intraoperative bleeding in embolized and nonembolized patients [14,16] and found higher JNA relapse rates among embolized patients. Mc Combe et al suggested that preoperative embolization may compromise the identification of surgical margins as it reduces tumor size, consequently increasing chances of relapse [14,17].…”

Section: Discussionmentioning

confidence: 99%

“…Other studies show blood loss reduced by 836-1200 ml per non embolised patient and by 400-600 ml per embolised patient [14].Nicolai et al reported amount of blood loss in 15 patients after embolisation as mean of 372 ml [6].…”

Section: Discussionmentioning

confidence: 99%

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

Janakiram¹,

Sharma²,

Panicker³

2016

Indian J Otolaryngol Head Neck Surg

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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.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

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

Janakiram¹,

Sharma²,

Panicker³

2016

Indian J Otolaryngol Head Neck Surg

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

160

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Juvenile nasopharyngeal angiofibroma: A Systematic Review and Comparison of Endoscopic, Endoscopic‐Assisted, and Open Resection in 1047 Cases

Boghani

Husain²,

Kanumuri³

et al. 2013

The Laryngoscope

140

179

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Surgical Treatment of Non-embolized Patients with Nasoangiofibroma

Abstract: Resection of JNF types I-III was safely completed in non-embolized patients. The observed levels of intraoperative bleeding, occurrence of complications, and rates of recurrence were close to those seen in embolized patients as found in the literature.

Cited by 21 publications

References 24 publications

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

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

ICAR: endoscopic skull‐base surgery

Juvenile nasopharyngeal angiofibroma: A Systematic Review and Comparison of Endoscopic, Endoscopic‐Assisted, and Open Resection in 1047 Cases

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