Juvenile nasopharyngeal angiofibromas (JNA) are a rare benign but locally aggressive vascular tumor. Epidemiology Juvenile nasopharyngeal angiofibromas. Juvenile angiofibroma (JNA) is a benign tumor that tends to bleed and occurs in the nasopharynx of prepubertal and adolescent males. Home» Acta Otorrinolaringológica Española» Comprar Tratamiento quirúrgico del angiofibroma nasofaríngeo juvenil en pacientes pediátricos.
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National Center for Biotechnology InformationU. This article has been cited by other articles in PMC. Received Aug 21; Accepted Oct 7.
Unable to process the form. Intraoperative control of bleeding during the resection of nasopharyngeal angiofibromas can be achieved successfully by temporary clamping of the external carotid arteries in the neck External carotid clamping has been shown to assist in hemostasis of the tumor.
Imaging plays an important role in diagnosis, as biopsies should be avoided due to the risk of brisk hemorrhage, as well as nasofarnteo. Surgical resection either open or increasingly endoscopic is the treatment of choice, usually performed with pre-operative embolisation to help with haemostasis. angiofibrona
Tumor size was not associated with bleeding. Similarly, our patients ranged in age from 10 to 29 years, with a mean age of 16 years, and all were male.
It shows very aggressive behavior due to local invasiveness and is associated with various symptoms. Accessed December 31st, Sign up for our Email Newsletters.
Arterial embolization in the management of posterior epistaxis. Professor in the Department of Otolaryngology.
Nasopharyngeal angiofibroma: Our experience and literature review
Although nasal endoscopic surgery is safe, rapid, and effective, studies are needed to assess the importance of preoperative embolization and clamping of the external carotid artery in reducing intraoperative bleeding.
Biopsy should be avoided as to avoid extensive bleeding since the tumor is composed of blood vessels without a muscular coat. Discussion Juvenile nasopharyngeal angiofibromas present almost wngiofibroma in men aged 14—25 years 23 24 25 26 27 Endoscopic Ressection juvenjl Juvenile Angiofibroma: Int J Pediatr Otorhinolaryngol.
Non-surgical treatments are available, including the use of hormones estrogen, testosteroneradiation therapy, chemotherapy, and recently, embolization; however, surgery is considered the treatment of choice, with the route depending on the stage of the tumor and the overall condition of the patient 11,12, Seventeen patients required clamping of the external carotids and tumor embolization.
In addition, preoperative embolization may complicate the identification of the angiofigroma extent of surgical margins by reducing the tumor size and increasing the risk of relapse Plain radiographs no longer play a role in the workup of a suspected juvenile nasopharyngeal angiofibroma, however they may still be obtained in some instances during the assessment of nasal obstruction, or symptoms of sinus obstructions.
Several surgical approaches have been utilized for the removal of nasopharyngeal angiofibromas, including transnasal, transpalatal, transzygomatic, and transcervical accesses, in addition to lateral rhinotomy and mid-facial degloving, with or without extension to the upper lip or concomitant craniotomy 9.
Many studies highlight the benefit of preoperative arterial embolization to control bleeding intraoperative 16,29, The other 17 patients required only endoscopic surgery.
Methods We analyzed 20 patients with nasopharyngeal angiofibroma who underwent surgery in the otolaryngology service between and Read it at Google Books – Find it at Amazon.
Am J Clin Oncol. Case 7 Case 7. Preoperative embolisation of tumour may be of some use in reducing intraoperative bleeding. Endoscopic Surgery for Juvenile Angiofibroma: The first patient who underwent surgery in our department had a Fisch I tumor, but did not undergo embolization or clamping of the external carotid arteries.
Vascularization arises most frequently from the maxillary artery i. Int J Pediatr Otorhinolaryngol. All patients were male, and all had symptoms of progressive nasal obstruction and recurrent epistaxis. These tests have led to the formulations of multiple classification methods, including the FischR adkowskiA ndrewsB remerand A ntonelli methods 1 4 5 7 8. Squamous-cell carcinoma Adenocarcinoma Mucinous cystadenocarcinoma Large-cell lung carcinoma Rhabdoid carcinoma Sarcomatoid carcinoma Carcinoid Salivary gland—like carcinoma Adenosquamous carcinoma Papillary adenocarcinoma Giant-cell carcinoma.
Nasopharyngeal angiofibroma: Our experience and literature review
Of our 20 patients, only 2 underwent surgery without embolization, with these 2 showing significantly greater intraoperative bleeding than the 18 patients who underwent embolization. Some surgeons, however, do not routinely perform embolization preoperatively, finding that embolization is justified only in larger tumors Although these masses are thought to arise from the region of the sphenopalatine foramenthey are usually sizeable at diagnosis, frequently with extension medially into the nasopharynxlaterally into the pterygopalatine fossa and over time beyond, into the orbitparanasal sinusesintracranial cavity and infratemporal fossa.
Blood loss, which was mL in a non-embolized patient, was reduced to mL in embolized patients These classifications are very important in helping surgeons decide the appropriate surgical approach. Of angiofivroma 20 patients, only 2 underwent surgery without clamping of the external carotid arteries, with both showing more bleeding than the 18 who underwent surgery with clamping. On examination, it may be seen as a pale reddish-blue mass. Nasal cavity, paranasal sinuses, nasopharynx Other tumors Nasopharyngeal angiofibroma Author: In addition, preoperative embolization may complicate the identification of the full extent of surgical margins by reducing the tumor size and increasing the risk of relapse This feature may be helpful is differentiating from other more aggressive lesions.
This relatively low blood loss may be due to the angiofiborma of surgical endoscopy, providing better control of bleeding than open surgery, with or without endoscopy.
The most significant risk is blindness, for patients with occlusion of the ophthalmic or angiofibromq cerebral artery through the collateral circulation. Sociedade Brasileira de Otorrinolaringologia. Case 2 Case 2.
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