Mohamed Abdelwahab1,2, Jonathan B Overdevest1, Ali Elmokadem3, Hossam El-Sisi2, Noha Ahmed El-Kholy2, Hesham Zaki2, Elsharawy Kamal2, Yasser Khafagy2, Ali Tawfik2, Hany Eldawoody4,5, Peter Hwang1, Abdelwahab Rakha2. 1. 1 Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA. 2. 2 Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt. 3. 3 Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt. 4. 4 Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt. 5. 5 Department of Neurosurgery, Prince Mohamed Bin Abdul-Aziz Hospital, Riyadh, Saudi Arabia.
Abstract
OBJECTIVE: To develop a systematic method for anatomic mapping of juvenile nasopharyngeal angiofibroma (JNA) tumors to standardize communication, facilitate surgical planning, and convey prognosis. STUDY DESIGN: Retrospective cohort. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Following Institutional Review Board approval, we performed a retrospective review of radiologic and angiographic data of patients with JNA presenting to the Department of Otolaryngology-Head and Neck Surgery, Mansoura University, from 2001 to 2017. All patients underwent angiography with embolization and had >1-year follow-up. Based on frequently involved anatomic sites and factors predictive of prognosis, the NSF-COR staging system (nose/nasopharynx, sinus, fossa-cranium, orbit, residual internal carotid artery supply) was developed to explicitly convey anatomic site of involvement and presence of residual vascularity. We validated the NSF-COR staging system against other systems with Pearson chi-square test based on risk factors and clinical outcomes of blood transfusion volume, recurrence, and JNA resectability. RESULTS: Fifty-four patients met inclusion criteria, where all primary cases (100%) demonstrated nose/nasopharynx involvement, followed by sinus (85.2%), natural fossae (85.2%), intracranial (26%), and orbital involvement (16.7%). These sites, with assessment of residual internal carotid artery vascular supply, were used to develop the NSF-COR anatomically based staging system. The components COR showed significant association with clinical outcomes of blood transfusion and recurrence. Contingency coefficients between the NSF-COR staging system and available staging systems showed significant correlations (P < .05) for prognosis. CONCLUSION: The NSF-COR staging system conveys a communicable anatomic map of JNA tumors that integrates residual vascularity of the tumor and demonstrates strong concordance with current staging systems to assess clinical outcomes.
OBJECTIVE: To develop a systematic method for anatomic mapping of juvenile nasopharyngeal angiofibroma (JNA) tumors to standardize communication, facilitate surgical planning, and convey prognosis. STUDY DESIGN: Retrospective cohort. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Following Institutional Review Board approval, we performed a retrospective review of radiologic and angiographic data of patients with JNA presenting to the Department of Otolaryngology-Head and Neck Surgery, Mansoura University, from 2001 to 2017. All patients underwent angiography with embolization and had >1-year follow-up. Based on frequently involved anatomic sites and factors predictive of prognosis, the NSF-COR staging system (nose/nasopharynx, sinus, fossa-cranium, orbit, residual internal carotid artery supply) was developed to explicitly convey anatomic site of involvement and presence of residual vascularity. We validated the NSF-COR staging system against other systems with Pearson chi-square test based on risk factors and clinical outcomes of blood transfusion volume, recurrence, and JNA resectability. RESULTS: Fifty-four patients met inclusion criteria, where all primary cases (100%) demonstrated nose/nasopharynx involvement, followed by sinus (85.2%), natural fossae (85.2%), intracranial (26%), and orbital involvement (16.7%). These sites, with assessment of residual internal carotid artery vascular supply, were used to develop the NSF-COR anatomically based staging system. The components COR showed significant association with clinical outcomes of blood transfusion and recurrence. Contingency coefficients between the NSF-COR staging system and available staging systems showed significant correlations (P < .05) for prognosis. CONCLUSION: The NSF-COR staging system conveys a communicable anatomic map of JNA tumors that integrates residual vascularity of the tumor and demonstrates strong concordance with current staging systems to assess clinical outcomes.
Authors: Salomon Cohen-Cohen; Kristen M Scheitler; Garret Choby; Jeffrey Janus; Eric J Moore; Jan L Kasperbauer; Harry J Cloft; Michael Link; Jamie J Van Gompel Journal: J Neurol Surg B Skull Base Date: 2021-03-02
Authors: Neeraj V Suresh; Viraj N Shah; David Matichak; Michael K Ghiam; Luke J Pasick; Isaac J Abecassis; Ali G Saad; Jacques Morcos; Zoukaa Sargi; Rita Bhatia Journal: Radiol Case Rep Date: 2022-07-29