S Girish Rao1, K Sudhakara Reddy, S Sampath. 1. Department of Oral and Maxillofacial Surgery, RV Dental College & Hospital, Bangalore, India. girishrao66@gmail.com
Abstract
INTRODUCTION: The mainstay treatment for Juvenile Nasopharyngeal Angiofibroma (JNA) is complete excision. Surgical approach should allow maximal exposure of the tumour with minimum morbidity. One such possible approach is Lefort I maxillary osteotomy. OBJECTIVE: To review our experience on feasibility of Lefort I osteotomy approach to achieve the best result and to look at the outcome in our series of patients at a tertiary centre in India. METHOD: This prospective study involves 22 patients with JNA who have been treated by Lefort I approach between August 2006 and December 2007 at the Department of Neurosurgery, National Institute of Mental Health And Neurosciences, Bangalore, India. RESULTS: All patients underwent primary surgical resection through Lefort I approach. No major intra-operative and post-operative complications were noted except in one patient where loss of vision in one eye due to prior pre-operative orbital involvement. The mean follow-up period was 2.8 years. To date, there has been no cases of residual tumour or recurrence that can be attributed to the procedure except in one case. CONCLUSION: Our experience suggests that the Lefort I osteotomy approach is a useful technique for the removal of extensive JNA which has distinct advantages over traditional approaches, providing a more direct vision, improved exposure, and cosmesis.
INTRODUCTION: The mainstay treatment for Juvenile Nasopharyngeal Angiofibroma (JNA) is complete excision. Surgical approach should allow maximal exposure of the tumour with minimum morbidity. One such possible approach is Lefort I maxillary osteotomy. OBJECTIVE: To review our experience on feasibility of Lefort I osteotomy approach to achieve the best result and to look at the outcome in our series of patients at a tertiary centre in India. METHOD: This prospective study involves 22 patients with JNA who have been treated by Lefort I approach between August 2006 and December 2007 at the Department of Neurosurgery, National Institute of Mental Health And Neurosciences, Bangalore, India. RESULTS: All patients underwent primary surgical resection through Lefort I approach. No major intra-operative and post-operative complications were noted except in one patient where loss of vision in one eye due to prior pre-operative orbital involvement. The mean follow-up period was 2.8 years. To date, there has been no cases of residual tumour or recurrence that can be attributed to the procedure except in one case. CONCLUSION: Our experience suggests that the Lefort I osteotomy approach is a useful technique for the removal of extensive JNA which has distinct advantages over traditional approaches, providing a more direct vision, improved exposure, and cosmesis.