Literature DB >> 23119910

Juvenile nasopharyngeal angiofibromas: A study of recurrence pattern and role of pre-Operative embolization - 'a decade'S experience'.

A M Shenoy1, N Grover, N Janardhan, P Njayakumar, T Hegde, S Satish.   

Abstract

UNLABELLED: This study is a retrospective analysis of 30 consecutive cases of Juvenile Nasopharyngeal Angiofibroma (JXA) operated at. Department of Head and Neck Surgery, Kidwai Memorial Institute of Oncology Bangalore, India: la tertiary referral centre) after prior emohilization by an interventional neuro-radiologisl (1996-2002). This study discusses critically the planning of surgical approach, based on anatomico-radiological factors and highlights the efficacy of preoperalive embolization in expediting total re moral of the tumor in 25 out of JO cases with advanced stage JNA.
OBJECTIVES: To analyze the utility of pre-operatire embolisation in surgical extirpation of large JNAs; planning of the surgical approaches based on CT topography of the tumor; to study the various complications of embolisation and surgery associated with JXA & lastly to evaluate the puttern and location of recurrent tumor thus correlating with the original topography.
SETTING: Tertiary care cancer referral centre. PATIENTS: PATIENTS ranged in age from ')- 24 years. all being males.
INTERVENTIONS: Majority of them were accessed by transfacial surgical approach(26). and in the recent past via midfacial degloving(4) within 4H hours of angioembolisation.
RESULTS: Complete removal of the tumor was achieved in 25 out of 30 cases with advanced stage JNA.Post surgical CT scans revealed tumor residua in 5 individuals, where the tumor was documented in - the temporal fossa 12), para-cavernous sinus region (I), cavernous sinus! I) and pterygo palatine fossa (I). Only the lesion in pterygopalaline fossa was successfully re-i>xcised & this alongwith the recurrence at para-cavernous & cavernous sinus & another were treated with radiotherapy; the 2 cases in the temporal fossa are under observation. The average blood loss during the procedure was 546.60 ml.
CONCLUSIONS: Today, advances in radiologie imaging-complemented by interventional neuro-radiological expertise in angio-embolisation have expedited complète excision with minimal morbidity and acceptable recurrence rate. This study has justified pre-operative embolisation and M currently the standard of care for advanced JXA.

Entities:  

Keywords:  Juvenile nasopharyngeal angiofibroma; embolisation; tumor recurrence

Year:  2002        PMID: 23119910      PMCID: PMC3450459          DOI: 10.1007/BF02993742

Source DB:  PubMed          Journal:  Indian J Otolaryngol Head Neck Surg        ISSN: 2231-3796


  11 in total

1.  Juvenile nasopharyngeal angiofibroma: management and therapy.

Authors:  A W Scholtz; E Appenroth; K Kammen-Jolly; L U Scholtz; W F Thumfart
Journal:  Laryngoscope       Date:  2001-04       Impact factor: 3.325

2.  [Preoperative embolization in the treatment protocol for rhinopharyngeal angiofibroma: comparison of the effectiveness of various materials].

Authors:  M De Vincentiis; A Gallo; A Minni; E Torri; R Tomassi; C Della Rocca
Journal:  Acta Otorhinolaryngol Ital       Date:  1997-06       Impact factor: 2.124

3.  Intracranial juvenile nasopharyngeal angiofibroma.

Authors:  A C Gupta; D P Murthy
Journal:  Aust N Z J Surg       Date:  1997-07

4.  Intranasal endoscopic excision of a juvenile angiofibroma.

Authors:  M T Mitskavich; R L Carrau; C H Snyderman; J L Weissman; J J Fagan
Journal:  Auris Nasus Larynx       Date:  1998-01       Impact factor: 1.863

5.  Nasopharyngeal angiofibromas: selecting a surgical approach.

Authors:  J J Fagan; C H Snyderman; R L Carrau; I P Janecka
Journal:  Head Neck       Date:  1997-08       Impact factor: 3.147

6.  Evaluation of the effectiveness of preoperative embolization in surgery for nasopharyngeal angiofibroma.

Authors:  J R Li; J Qian; X Z Shan; L Wang
Journal:  Eur Arch Otorhinolaryngol       Date:  1998       Impact factor: 2.503

7.  Radiation therapy for juvenile angiofibroma: evaluation by CT and MRI, analysis of tumor regression, and selection of patients.

Authors:  M E Kasper; J T Parsons; A A Mancuso; W M Mendenhall; S P Stringer; N J Cassisi; R R Million
Journal:  Int J Radiat Oncol Biol Phys       Date:  1993-03-15       Impact factor: 7.038

8.  Flutamide-induced regression of angiofibroma.

Authors:  G A Gates; D H Rice; C F Koopmann; D E Schuller
Journal:  Laryngoscope       Date:  1992-06       Impact factor: 3.325

9.  Angiofibroma. Changes in staging and treatment.

Authors:  D Radkowski; T McGill; G B Healy; L Ohlms; D T Jones
Journal:  Arch Otolaryngol Head Neck Surg       Date:  1996-02

10.  Long-term follow-up of juvenile nasopharyngeal angiofibromas: analysis of recurrences.

Authors:  P Herman; G Lot; R Chapot; D Salvan; P T Huy
Journal:  Laryngoscope       Date:  1999-01       Impact factor: 3.325

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  1 in total

1.  Endoscopic excision of Juvenile nasopharyngeal angiofibroma - A comprehensive approach.

Authors:  R A Bradoo; S N Muranjan; N K Nerurkar; A A Joshi; P H Achar
Journal:  Indian J Otolaryngol Head Neck Surg       Date:  2003-10
  1 in total

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