Juvenile nasopharyngeal angiofibroma stages I and II: A comparative study of surgical approaches

Summary Objective The aim of this study was to compare different surgical options used for removal of stages I and II juvenile nasopharyngeal angiofibromas (JNAs). Treatment morbidity was evaluated through blood loss, surgery duration, postoperative hospitalization and outcome. Moreover, an effort w...

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Published in:International journal of pediatric otorhinolaryngology 2008-06, Vol.72 (6), p.793-800
Main Authors: Yiotakis, Ioannis, Eleftheriadou, Anna, Davilis, Dimitrios, Giotakis, Evagelos, Ferekidou, Eliza, Korres, Stavros, Kandiloros, Dimitrios
Format: Article
Language:English
Subjects:
Adolescent
Angiofibroma - pathology
Angiofibroma - surgery
Blood loss
Blood Loss, Surgical
Child
Embolization, Therapeutic
Endoscopy
Humans
JNA treatment
Length of Stay - statistics & numerical data
Male
Nasopharyngeal Neoplasms - pathology
Nasopharyngeal Neoplasms - surgery
Neoplasm Recurrence, Local - surgery
Otolaryngology
Otorhinolaryngologic Surgical Procedures - methods
Pediatrics
Preoperative Care
Selective embolization
Time Factors
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Summary:Summary Objective The aim of this study was to compare different surgical options used for removal of stages I and II juvenile nasopharyngeal angiofibromas (JNAs). Treatment morbidity was evaluated through blood loss, surgery duration, postoperative hospitalization and outcome. Moreover, an effort was made to explore the role and limits of endoscopic surgery. Materials and methods 20 male patients (mean age 14.9 years) were treated for JNA using three different surgical approaches in the Department of Otolaryngology of the University of Athens between May 1998 and January 2007. 9 patients were managed using endoscopic approach, while 5 were treated through midfacial degloving. A transpalatal approach was performed in remaining 6 patients. Preoperative angiography with embolization was performed in all 9 patients who underwent endoscopic removal and in 3 patients treated by midfacial degloving technique. Results Findings demonstrated that endoscopic approach, assisted by preoperative embolization, lead to less intraoperative blood loss, shorter duration of surgical procedure, shorter length of hospital stay and no complications, compared with the conventional techniques. Conclusions Our data suggest that with proper patient selection, endoscopic resection of stages I and II JNA, when it is performed after embolization of the feeding vessels, is remarkably bloodless and precise and may be preferable to traditional open approaches.
ISSN:0165-5876
1872-8464
DOI:10.1016/j.ijporl.2008.02.007