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Treatment and prognosis of nasopharyngeal angiofibroma involving the eye and optic nerve

Published online by Cambridge University Press:  04 September 2012

Y Xu ,
G Lin ,
C Lin ,
Z Fang ,
Z Li ,
A Zhou ,
S Lan ,
G Xu  and
Z Yi
Y Xu
Affiliation:
Department of ENT, Otolaryngology Institute of Fujian Province, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
G Lin
Affiliation:
Department of ENT, Otolaryngology Institute of Fujian Province, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
C Lin
Affiliation:
Department of ENT, Otolaryngology Institute of Fujian Province, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
Z Fang
Affiliation:
Department of Imaging, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China Institutional Review Board of the Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
Z Li
Affiliation:
Department ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China Institutional Review Board of the Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
A Zhou
Affiliation:
Department ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China Institutional Review Board of the Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
S Lan
Affiliation:
Department ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China Institutional Review Board of the Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
G Xu
Affiliation:
Department Ophthalmology, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China Institutional Review Board of the Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
Z Yi*
Affiliation:
Department of ENT, Otolaryngology Institute of Fujian Province, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
*
Address for correspondence: Dr Zixiang Yi, Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China Fax: +86 591 87982780 E-mail: [email protected]
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Abstract

Objective:

To discuss the minimally invasive treatment and prognosis of juvenile nasopharyngeal angiofibroma involving the eye and optic nerve.

Methods:

Retrospective analysis of clinical data for 18 large juvenile nasopharyngeal angiofibromas, with reports of three typical cases.

Results:

The tumour invaded the orbit, eye, optic nerve and optic chiasm in 18, 9, 8 and 5 patients, respectively. Twelve patients were cured after surgery, with the affected eye and vision essentially returning to normal. In six patients, tumour residue was found in the middle cranial fossa; two of these six did not return for follow up. Four patients underwent radiotherapy; all four regained placement of the eye in a normal or near-normal position. One of these four patients regained normal visual acuity, two experienced no improvement in visual acuity, and one became blind.

Conclusion:

In patients with this tumour, surgery may return the eye to the normal position and may restore visual acuity if the optic fundus, macula, retina and optic nerve are only mildly affected. Modern radiotherapy can treat the intracranial residue effectively. A combined approach via the antrum, infratemporal fossa and nasal cavity, using a Caldwell–Luc incision, provides minimally invasive surgical access.

Keywords

NasopharynxAngiofibromaEyeOptic NervePathology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 11 , November 2012 , pp. 1108 - 1113
Copyright
Copyright © JLO (1984) Limited 2012

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