The risk factors for residual juvenile nasopharyngeal angiofibroma and the usual residual sites

Juvenile nasopharyngeal angiofibroma (JNA) is non-metastasizing but potentially locally destructive tumor of the nasopharynx. It can destroy the skull base and invade into the cerebrum. Surgical management is the primary standard but residual disease is always a risk factor. We aimed to determine th...

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Bibliographic Details
Published in:American journal of otolaryngology 2019-05, Vol.40 (3), p.343-346
Main Authors: Liu, Zhuofu, Hua, Wei, Zhang, Huankang, Wang, Jingjing, Song, Xiaole, Hu, Li, Lu, Hanyu, Wang, Dehui
Format: Article
Language:English
Subjects:
Age
Bleeding
Canals (anatomy)
Cerebrum
Disease control
Embolisms
Endoscopy
Health risks
Hospitals
Juvenile nasopharyngeal angiofibroma
Magnetic resonance imaging
Medical imaging
Medical records
Nasopharynx
NMR
Nuclear magnetic resonance
Patients
Postoperative imaging
Radiation therapy
Residual site
Risk analysis
Risk factors
Risk factors for recurrence
Sinuses
Statistical analysis
Surgeons
Surgery
Surgical instruments
Tumors
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Summary:Juvenile nasopharyngeal angiofibroma (JNA) is non-metastasizing but potentially locally destructive tumor of the nasopharynx. It can destroy the skull base and invade into the cerebrum. Surgical management is the primary standard but residual disease is always a risk factor. We aimed to determine the risk factors for residual disease and usual sites for these residual tumors. The medical records of 131 patients (mean age 17.6 ± 6.8, range 9–71 years) with histologically proven JNA were retrospectively analyzed. The surgeries were all nasal endoscopic approaches, with or without assistant incision. The prevalence of residual disease was 16.8%. Risk factors associated with JNA recurrence included tumor stage, intraoperative bleeding, and the year in which the operation was performed. The pterygoid canal, pterygoid process, and pterygopalatine foramen were the most frequent locations for residual tumor. Surgical management should take particular care for the pterygoid canal, petrygoid process, and pterygopalatine foramen. Contrast-enhanced CT and MRI are effective tools to evaluate complete JNA excision in the first two days after primary surgery. Careful exploration of these areas may be the key to avoid residual JNA.
ISSN:0196-0709
1532-818X
DOI:10.1016/j.amjoto.2018.11.010