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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Seventeen patients required clamping of the external carotids and tumor embolization. Tumors may invade the anterior fossa through the ethmoid and sphenoid sinuses, being more frequent in the middle fossa and remaining extradural 8 9 To minimize complications, surgery should be performed at centers with extensive experience. The tumors are frequently located in the posterolateral wall of the nasal cavity, where the sphenoid process of the palatine bone articulates with the base of the pterygoid process, forming the sphenopalatine foramen.
Plain radiographs no longer play a role in the workup of a suspected juvenile nasopharyngeal angiofibroma, however they may still be obtained in some angiofibrom during the assessment of nasal nasofafngeo, or symptoms of sinus obstructions.
Since then, several cases have been reported, all showing angiofbiroma endoscopic resection resulted in nasofanrgeo morbidity during the early stages of disease Check for errors and try again. Since then, several cases have been reported, all showing that endoscopic resection resulted in lower morbidity during the early stages of disease Juvenile nasopharyngeal angiofibroma is a rare, highly vascular, and histologically benign tumor, generally observed in male adolescents.
The tumor invades the infratemporal fossa or orbit without intracranial involvement. Nasal cavity, paranasal sinuses, nasopharynx Other tumors Nasopharyngeal angiofibroma Author: Find articles by Francis Vinicius Fontes de Lima.
The 18 nasofarbgeo who underwent embolization did so h prior to surgery Figure 5. Treatment trends in patients during 40 years. Studies comparing surgical treatment with or without embolization have shown that preoperative embolization reduced intraoperative blood loss and the angiofibrooma for replacement of blood products 31 Surgical methods in all patients were based on Fisch classifications.
The presentation is typically with obstructive symptoms, epistaxisand chronic otomastoiditis due to obstruction of the Eustachian tube. Blood loss, which was mL in a non-embolized patient, was reduced to mL in embolized patients Treatment for Nasopharyngeal angiofibroma JNA is primarily surgical.
The exact site of origin is contentious as these masses usually present when they have reached considerable size. A comparative study of surgical approches. Retrospective, descriptive study conducted after approval from the Ethics Committee of the Federal University of Sergipe protocol The first description of an endoscopic resection was published in Juvenile nasopharyngeal angiofibromas are benign but highly vascular tumours.
The development of minimally invasive techniques has led to the increased juvehil of endoscopic surgery for the treatment of nasopharyngeal angiofibroma 21making it ideal for tumors confined to the nasopharynx, nasal cavity, and sphenoid sinus with minimal extension into the pterygopalatine fossa 10 12 13 15 18 Maurice M, Milad M.
From a triangular region formed by the foramen ovale, a round and lacerated tumor may reach the middle fossa, migrating to the parasellar region and remaining generally extradual and lateral to the cavernous sinus. The volume of intraoperative bleeding has been shown to be similar in patients with and without embolization 34whereas tendency to relapse was greater in patients undergoing embolization. Definitive Radiotherapy for Juvenile Nasopharyngeal Angiofibroma.
We also found that patients who underwent clamping of the external carotid artery and embolization showed less intraoperative bleeding than patients who underwent embolization alone. None of our patients experienced complications due to embolization.
Surgery of cranial base tumors. All 20 patients were available for follow-up maximum, 7 yearswith none showing evidence of tumor recurrence.
Nasopharyngeal angiofibroma: Our experience and literature review
Combined surgery consisting of a craniotomy, degloving, and endoscopic surgery in a patient with a Fisch IVA tumor. Recurrence in juvenile angiofibroma. Moreover, the mean blood loss in these patients was mL. Olfactory neuroblastoma Olfactory neuroblastoma.
Some surgeons, however, do not routinely perform embolization preoperatively, finding that embolization is justified only in larger tumors CT is particularly useful at delineating bony changes.
Pathology Outlines – Nasopharyngeal angiofibroma
Supply of these tumours is usually via Arch Nasogarngeo Head Neck Surg. National Center for Biotechnology InformationU. The other 17 patients required only endoscopic surgery. This page was last edited on 29 Septemberat Many studies highlight the benefit of preoperative arterial embolization to control bleeding intraoperative 16 29 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 naasofarngeo of the patient 11 12 Synonyms or Alternate Spellings: Maurice M, Milad M.
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 Consistent with previous results, we found that the mean operation time in the 17 patients who underwent endoscopic surgery alone was min The combination of different accesses to the tumor can be required 9.
Intricate mixture of stellate and staghorn blood vessels with variable vessel wall thickness ranging from single layer of endothelium to variable smooth muscle coat Irregular fibrous stroma loose, edematous to dense, acellular Stromal cells are stellate fibroblasts with small pyknotic to large vesicular nuclei Larger vessels at base of lesion, smaller vessels with plump endothelial cells at growing edge of tumor Multinucleated stromal cells are common Mitotic figures are rare Minimal inflammation.
Surgery difficult to excisepreoperative embolization or antiandrogen therapy Chemotherapy or radiation therapy if advanced or aggressive. Transcatheter arterial embolization in nasopharyngeal angiofibroma.
Examinations such as computed tomography, nuclear magnetic resonance and even nasal endoscopy can clearly establish the extent of the tumor, its pattern of spread, and consequently, surgical planning 10 11 12 16 17 18