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Angiofibroma: an outcome review of conventional surgical approaches

  • Head and Neck Oncology
  • Published:
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Abstract

Juvenile nasopharyngeal angiofibroma (JNA) is a benign tumor of the nasopharynx, and for its treatment, many surgical approaches have been recommended. However, selecting the appropriate one for the tumor in an advanced stage is still controversial. In this study, we evaluate the rate of recurrence of JNA and its relationship to the preoperative stage as well as various surgical approaches. Thirty-seven patients with pathologically proven JNA were retrospectively analyzed. For each patient, data were obtained regarding the primary extension, various surgical approaches and rate of recurrence. Seven patients were in stage III with intracranial extensions. Two of these patients had symptomatic recurrence that needed surgery. Three of them were disease free, and in two cases residues were demonstrated that were asymptomatic and were chosen only to be observed. Among different surgical approaches used, the transpalatal resulted in 1 recurrence out of 14 patients treated with this approach when the lesion was limited to the nasal cavity, nasopharynx and paranasal sinuses (stage I). No recurrence was observed with the use of this approach with lesions with minimal extension to the pterygopalatine fossa (stage IIA). But among three patients with intracranial extension who were treated with this approach, two resulted in symptomatic recurrence; however, using the Lefort I surgical technique, no evidence of recurrence was observed in the two patients in stage III who were treated with this approach. Involvement of the orbit, middle cranial fossa and base of the pterygoid by the primary JNA results in a higher incident of recurrent tumor. Among different surgical techniques, the lowest recurrence rate is seen either in the transpalatal approach when the tumor is limited to the nasopharynx with extension to the nasal cavity or paranasal sinuses or with the Lefort I approach when skull base invasion is present.

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Author information

Authors and Affiliations

  1. Department of ENT of Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Seyed Mousa Sadr Hosseini

  2. Department of ENT of Amir-Alam Hospital, Tehran University of Medical Sciences, North Sa‘di Avenue, 11457, Tehran, Iran

    Peyman Borghei, Seyed Hebatodin Borghei & Mohammad Taghi Khorsandi Ashtiani

  3. Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, MI, USA

    Ali Shirkhoda

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  1. Seyed Mousa Sadr Hosseini
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  2. Peyman Borghei
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  3. Seyed Hebatodin Borghei
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  4. Mohammad Taghi Khorsandi Ashtiani
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  5. Ali Shirkhoda
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Correspondence to Peyman Borghei.

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Hosseini, S.M.S., Borghei, P., Borghei, S.H. et al. Angiofibroma: an outcome review of conventional surgical approaches. Eur Arch Otorhinolaryngol 262, 807–812 (2005). https://doi.org/10.1007/s00405-004-0910-1

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  • DOI: https://doi.org/10.1007/s00405-004-0910-1

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