Advertisement

Juvenile Nasopharyngeal Angiofibroma: Combined Approach for Excision, Transpalatal and Endoscopic; A New Perspective

  • Ritu Gupta
  • Satya Prakash Agarwal
Original Article
  • 54 Downloads

Abstract

Juvenile angiofibroma is a rare, highly vascular, histologically benign but locally invasive tumour, affecting predominantly male adolescents. To describe our experience in diagnosis of angiofibroma and treatment by combined endoscopic and transpalatal route. We analysed a case series of 50 patients of nasopharyngeal angiofibroma in Fisch stages I and II who presented at our institute during a period of four years 2011–2014, their clinical presentation, their treatment by combined transpalatal and endoscopic approach, intraoperative and post operative course, complications and tumour recurrence. Patients were aged 8–26 years. All patients were treated surgically by combined approach endoscopic and transpalatal. The mean operation time was 90 min, and the mean bleeding volume was 300 ml. Only 8 % patients came with recurrence and only 10 % came with palatal perforation (fistula formation). With gratifying results we advocate this novel technique for the treatment of early to intermediate JNA.

Keywords

Angiofibroma Transpalatal Endoscopic 

Notes

Compliance with Ethical Standards

Conflicts of interest

None.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Full written consent was taken from the patients regarding the nature of the treatment and further use of his photographs and details for the publishing.

References

  1. 1.
    Wormald PJ, Hasselt A (2003) Endoscopic removal of juvenile angiofibroma. Otolaryngol Head Neck Surg 129:684–691. doi: 10.1016/S0194-5998(03)01580-8 CrossRefPubMedGoogle Scholar
  2. 2.
    Sinha V, Ninama M, Prajapati B, Gupta D, More Y, Bhat V, Singh SN (2009) Juvenile nasopharyngeal angiofi broma—our experience at a referral hospital. Indian J Otolaryngol Head Neck Surg 61(Suppl 1):17–21CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Chmielik LP, Frackiewicz M, Krajewski R et al (2009) Perioperative problems and treatment of a teenager with a juvenile angiofibroma refusing blood transfusion. Int J Pediatr Otorhinolaryngol 73:689–692CrossRefPubMedGoogle Scholar
  4. 4.
    Baser B, Kothari S, Kinger A (2011) Endoscopic approach to fisch stage II to III-b juvenile nasopharyngeal angiofibroma. Indian J Otolaryngol Head Neck Surg. 63(1):1–4CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Andrews JC, Fisch U, Valavanis A, Aeppli U, Makek MS (1989) The surgical management of extensive nasopharyngeal angiofibromas with the infratemporal fossa approach. Laryngoscope 99:429–437CrossRefPubMedGoogle Scholar
  6. 6.
    Wiatrak BJ, Koopmann CF, Turrisi AT (1993) Radiation therapy as an alternative to surgery in the management of intracranial juvenile nasopharyngeal angiofibroma. Int J Pediatr Otorhinolaryngol 51(28):51–61CrossRefGoogle Scholar
  7. 7.
    Panda N, Gupta G, Sharma S, Gupta A (2012) Nasopharyngeal Angiofibroma-changing trends in the management. Indian J Otolaryngol Head Neck Surg 64(3):233–239CrossRefGoogle Scholar
  8. 8.
    Ardehali MM, Samimi SH, Bakhshaee M (2014) An effective technique for endoscopic resection of advanced stage angiofibroma. Iran J Otorhinolaryngol 26(74):25–30Google Scholar
  9. 9.
    Mendonça CA, de Jesus EPF, Santos ACG, Barreto VMP, Santos RC Jr (2013) Nasopharyngeal angiofibroma: Our experience and literature review. Int Arch Otorhinolaryngol 17(1):14–19PubMedPubMedCentralGoogle Scholar
  10. 10.
    Desarda KK, Bora MP (1998) Importance of pre-operative embolization in the surgery of nasopharyngeal angiofibroma. Indian J Otolaryngol Head Neck Surg 50(1):36–39CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Ghosh B, Saha S, Chandra S, Nandi TK, Bera SP (2003) Juvenile nasopharvngeal angiofibroma—three years experience. Indian J Otolarvngol Head Neck Surg 55(4):228–233CrossRefGoogle Scholar
  12. 12.
    Sinha A, Gupta S (2000) Nasopharyngeal angiofibroma : staging and management—a review of the case series report. Indian J Otolaryngol Head Neck Surg 52(4):366–370PubMedPubMedCentralGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2016

Authors and Affiliations

  1. 1.Department of ENT Head and Neck SurgeryKing George Medical UniversityLucknowIndia

Personalised recommendations