Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization
Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign neoplasm that occurs almost exclusively in the nasopharynx of adolescent males. Surgery remains the primary treatment of choice. JNA has always presented a management challenge to surgeons because of its vascular nature, site of occurrenc...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2008
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/28820/1/raja_et_al_2008.pdf http://irep.iium.edu.my/28820/ http://www.e-asianjournalsurgery.com/article/S1015-9584(08)60081-0/abstract |
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| Summary: | Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign neoplasm that occurs almost exclusively in
the nasopharynx of adolescent males. Surgery remains the primary treatment of choice. JNA has always
presented a management challenge to surgeons because of its vascular nature, site of occurrence, and
local tissue destruction. The surgical approaches are either standard open method which include external
or intraoral incisions, or the recent advanced approach, i.e. via using the endonasal endoscope. It is widely
accepted that the use of preoperative angiographic embolization reduces the occurrence of intraoperative
bleeding and facilitates tumour removal. However, angiographic embolization is not available at all centres.
The purpose of this article is to present our experience with five patients diagnosed with JNA who
were resected without embolization, using various surgical approaches. Two tumours were removed via
endonasal endoscopic surgery. None of the tumours were embolized prior to surgery. We highlight the
preoperative evaluation of tumour extent, using both computed tomography (CT) and magnetic resonance
angiography, and the importance of temporary clamping of the external carotid artery intraoperatively.
Our results suggest that the latter procedure is a safe and effective means of facilitating surgery
and reducing intraoperative bleeding. [Asian J Surg 2008;31(4):174–8] |
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