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Juvenile nasopharyngeal angiofibroma: a single centre's 11-year experience

Published online by Cambridge University Press:  22 October 2018

A E Pamuk ,
S Özer ,
A E Süslü ,
A Akgöz  and
M Önerci
A E Pamuk*
Affiliation:
Department of Otorhinolaryngology, Akyurt State Hospital, Ankara, Turkey
S Özer
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
A E Süslü
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
A Akgöz
Affiliation:
Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
M Önerci
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
*
Author for correspondence: Dr Ahmet Erim Pamuk, Department of Otorhinolaryngology, Akyurt State Hospital, 06750 Akyurt – Ankara, Turkey E-mail: [email protected] Fax: +90 312 844 3016
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Abstract

Objective

This study aimed to present the clinical features and surgical outcomes of juvenile nasopharyngeal angiofibroma patients who were surgically treated.

Methods

The medical records of 48 male patients histologically confirmed as having juvenile nasopharyngeal angiofibroma, who underwent transnasal endoscopic surgery between 2005 and 2016, were retrospectively reviewed.

Results

The overall recurrence rate was 20.8 per cent; however, the recurrence rate differed significantly between patients diagnosed aged less than 14 years (34.7 per cent) and more than 14 years (8 per cent) (p < 0.05). Advanced-stage tumours (Radkowski stage of IIC or more, and Önerci stage of III or more) were more aggressive than earlier stage tumours (p < 0.05 and p < 0.01, respectively). Pre-operative embolisation significantly prolonged mean hospitalisation duration, but had no effect on intra-operative blood loss in patients with advanced-stage tumours (p < 0.001 and p = 0.09, respectively).

Conclusion

The findings show that transnasal endoscopic surgery could be considered the treatment of choice for juvenile nasopharyngeal angiofibroma. Patients diagnosed when aged less than 14 years and those with advanced-stage tumours are at risk of recurrence, and should be monitored with extreme care.

Keywords

AngiofibromaNasopharynxEndoscopyNasal Surgical ProceduresEmbolizationTherapeutic
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 11 , November 2018 , pp. 978 - 983
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr A E Pamuk takes responsibility for the integrity of the content of the paper

References

1Midilli, R, Karci, B, Akyildiz, S. Juvenile nasopharyngeal angiofibroma: analysis of 42 cases and important aspects of endoscopic approach. Int J Pediatr Otolaryngol 2009;73:401–8Google Scholar
2Nicolai, P, Schreiber, A, Bolzoni Villaret, A. Juvenile angiofibroma: evolution of management. Int J Pediatr 2012;2012:412545Google Scholar
3Farag, MM, Ghanimah, SE, Ragaie, A, Saleem, TH. Hormonal receptors in juvenile nasopharyngeal angiofibroma. Laryngoscope 1987;97:208–11Google Scholar
4Coutinho-Camillo, CM, Brentani, MM, Nagai, MA. Genetic alterations in juvenile nasopharyngeal angiofibromas. Head Neck 2008;30:390–400Google Scholar
5Schick, B, Plinkert, PK, Prescher, A. Aetiology of angiofibromas: reflection on their specific vascular component [in German]. Laryngorhinootologie 2002;81:280–4Google Scholar
6Beham, A, Beham-Schmid, C, Regauer, S, Aubock, L, Stammberger, H. Nasopharyngeal angiofibroma: true neoplasm or vascular malformation? Adv Anat Pathol 2000;7:36–46Google Scholar
7Onerci, M, Ogretmenoglu, O, Yucel, T. Juvenile nasopharyngeal angiofibroma: a revised staging system. Rhinology 2006;44:39–45Google Scholar
8Radkowski, D, McGill, T, Healy, GB, Ohlms, L, Jones, DT. Angiofibroma. Changes in staging and treatment. Arch Otolaryngol Head Neck Surg 1996;122:122–9Google Scholar
9Herman, P, Lot, G, Chapot, R, Salvan, D, Huy, PT. Long-term follow-up of juvenile nasopharyngeal angiofibromas: analysis of recurrences. Laryngoscope 1999;109:140–7Google Scholar
10Nicolai, P, Villaret, AB, Farina, D, Nadeau, S, Yakirevitch, A, Berlucchi, M et al. Endoscopic surgery for juvenile angiofibroma: a critical review of indications after 46 cases. Am J Rhinol Allergy 2010;24:67–72Google Scholar
11Enepekides, DJ. Recent advances in the treatment of juvenile angiofibroma. Curr Opin Otolaryngol Head Neck Surg 2004;12:495–9Google Scholar
12Glad, H, Vainer, B, Buchwald, C, Petersen, BL, Theilgaard, SA, Bonvin, P et al. Juvenile nasopharyngeal angiofibromas in Denmark 1981–2003: diagnosis, incidence, and treatment. Acta Otolaryngol 2007;127:292–9Google Scholar
13Huang, Y, Liu, Z, Wang, J, Sun, X, Yang, L, Wang, D. Surgical management of juvenile nasopharyngeal angiofibroma: analysis of 162 cases from 1995 to 2012. Laryngoscope 2014;124:1942–6Google Scholar
14Howard, DJ, Lloyd, G, Lund, V. Recurrence and its avoidance in juvenile angiofibroma. Laryngoscope 2001;111:1509–11Google Scholar
15Sun, XC, Wang, DH, Yu, HP, Wang, F, Wang, W, Jiang, JJ. Analysis of risk factors associated with recurrence of nasopharyngeal angiofibroma. J Otolaryngol Head Neck Surg 2010;39:56–61Google Scholar
16Liu, L, Wang, R, Huang, D, Han, D, Ferguson, EJ, Shi, H et al. Analysis of intra-operative bleeding and recurrence of juvenile nasopharyngeal angiofibromas. Clin Otolaryngol Allied Sci 2002;27:536–40Google Scholar
17Li, JR, Qian, J, Shan, XZ, Wang, L. Evaluation of the effectiveness of preoperative embolization in surgery for nasopharyngeal angiofibroma. Eur Arch Otorhinolaryngol 1998;255:430–2Google Scholar
18Lutz, J, Holtmannspötter, M, Flatz, W, Meier-Bender, A, Berghaus, A, Brückmann, H et al. Preoperative embolization to improve the surgical management and outcome of juvenile nasopharyngeal angiofibroma (JNA) in a single center: 10-year experience. Clin Neuroradiol 2015;26:405–13Google Scholar
19Mohammadi, M, Saedi, B, Basam, A. Effect of embolisation on endoscopic resection of angiofibroma. J Laryngol Otol 2010;124:631–5Google Scholar
20Onerci, M, Gumus, K, Cil, B, Eldem, B. A rare complication of embolization in juvenile nasopharyngeal angiofibroma. Int J Pediatr Otorhinolaryngol 2005;69:423–8Google Scholar