TREATMENT OF JUVENILE NASOPHARYNGEAL ANGIOFIBROMA: OUR CLINICAL RESULTS
Gaziantep Üniversitesi, KBB ve Baş-Boyun Cerrahisi, Gaziantep, Türkiye Objectives: The aim of this retrospective study is to determine the clinical and radiological findings of the patients with juvenile nasopharyngeal angiofibroma (JNA), discuss the surgical approaches and evaluate the effectiveness of preoperative embolization .Patients and Methods: Fourteen cases of JNA were treated at our institution from January 1994 to March 2003. Transpalatal approach was the only surgical technique performed in all patients. Recurrences were seen in four patients following primary surgery. Two of the recurrences were treated with surgery alone and the other two were treated with surgery and radiotherapy. Tumors were staged according to the Fisch's staging scala. Preoperative embolization was performed in three cases.
Results: Transpalatal aproach was sufficient in stage-I and stage-II patients. In stage III and IV patients, four patients had recurrent tumors (29%). Transmaxillary approach was performed in one patient that had reccurent tumor. Transantral combined with endoscopic approach was also used in one patient with recurrent tumor. In the same patient, total endoscopic resection had to be added for residual tumor. Blood loss was significantly reduced in the embolization group. There was no complication of preoperative embolization.
Conclusion: Transnasal endoscopic examination with clinical symptoms were sufficient for the diagnosis of the JNA without preoperative tumor biopsy. Transpalatal surgical approach is a capable technique for treatment of JNA in stage-I and stage-II patients but it's not sufficient in stage III and stage-IV tumours.
Keywords : Juvenile Nasopharyngeal Angiofibroma, Surgery, Transpalatal