Alves F RA, Granato L, Maia M S. Acessos Cirúrgicos no Angiofibroma Nasofaríngeo Juvenil – Relato de caso e revisão de literatura. Arch Otolaryngol Head. Juvenile angiofibroma (JNA) is a benign tumor that tends to bleed and occurs in the nasopharynx of prepubertal and adolescent males. Transcript of ANGIOFIBROMA JUVENIL NASOFARINGEO. Estadio I – tumor confinado a la nasofaríngeo. Estadio II – tumor extendido a la.
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Our patients were classified using the Fisch system, the most widely used in most studies Figures 2 and 3. Olfactory neuroblastoma Olfactory neuroblastoma.
Juvenile nasopharyngeal angiofibroma | Radiology Reference Article |
The other 17 patients underwent endoscopic surgery alone. In the 17 patients who underwent endoscopic approach alone, the mean operation time was min and the mean blood loss was mL; none required replacement of blood products. Juvenile nasopharyngeal angiofibroma originates in the sphenopalatine forame, causing epistaxes and nasal obstruction.
Of the 20 patients, 3 had surgery by combined approaches conventional and endoscopicincluding 1 patient with a Fisch IIIA tumor who was treated by the Caldwell-Luc expanded technique and endoscopic surgery, 1 patient with a Fisch IIIA tumor who was treated by the degloving mid-facial technique and endoscopic surgery, and 1 with a Fisch IV tumor who was treated by the degloving mid-facial technique associated with craniotomy and endoscopic surgery.
Angiography, although not essential, is often useful in both defining the feeding vessels as well as in preoperative embolisation. In this study, we have described our experience in treating 20 patients with nasopharyngeal angiofibromas in the Department of Otorhinolaryngology.
These tests have led to the formulations of multiple classification methods, including the FischRadkowskiAndrewsBremerand Antonelli methods 1,4,5,7,8. We analyzed findings in 20 patients who underwent surgery between and New author database being installed, click here for details.
Endoscopic surgery alone or with other conventional techniques was safe for hasofaringeo treatment of angiofibromas of different stages. 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 The third patient with a Fisch I tumor underwent surgery with embolization, but without clamping of the external carotid arteries.
The mean operation time was min, and the mean bleeding volume was mL. Nasal cavity Esthesioneuroblastoma Nasopharynx Anyiofibroma carcinoma Nasopharyngeal angiofibroma Larynx Laryngeal angiofibrroma Laryngeal papillomatosis. Angiofibroma – rewiew of cases. If nasopharyngeal angiofibroma is angiofkbroma based on physical examination a smooth vascular submucosal mass in the posterior nasal cavity of nasofarihgeo adolescent maleimaging studies such as CT or MRI should be performed. The first description of an endoscopic resection was published in Blood loss, which was mL in a non-embolized patient, was reduced to mL in embolized patients CT is particularly useful at delineating bony changes.
Of our 20 patients, 3 required a combination of endoscopic and open surgery, with one, with a Fisch IIIA tumor, having expanded Caldwell-Luc and endoscopic techniques; one, with a Fisch IIIA tumor, undergoing mid-facial degloving and endoscopic surgery; and one, with a Fisch IVA tumor, having mid-facial degloving, craniotomy, and endoscopic surgery Figure 4. Nasal endoscopy, alone or combined with open techniques, was safe for the resection of angiofibromas at different stages, with low morbidity and high efficacy, as shown by complete tumor removal and low recurrence rates.
Long-term tumor recurrence has been reported due to incomplete initial resection.
Angiofibroma nasofaríngeo juvenil
Several classification methods have been utilized to stage tumors and assist in choosing the appropriate treatment. Am J Clin Oncol. Received Aug 21; Accepted Oct 7. Synonyms or Alternate Spellings: 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 nasofarringeo 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.
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. To minimize complications, surgery should be performed at centers with extensive experience.
Seventeen patients required clamping of the external carotids and tumor embolization. Embolization of a year-old patient with a Fisch IIIa juvenile nasopharyngeal angiofibroma. Case 4 Case 4.
The development of minimally invasive techniques has led to the increased use 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 Introduction Nasopharyngeal angiofibroma is a histologically and biologically benign tumor with aggressive behavior due to its location and associated symptoms including significant epistaxis and nasal obstruction 1 2 3 4 5.
Views Read Edit View history. Recent advances in the treatment of juvenile angiofibroma. Universidade Federal de Sergipe. 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.
The development of minimally invasive techniques has led to the increased use 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, Well circumscribed but unencapsulated polypoid fibrous mass, bleeds severely on manipulation and biopsy, may occlude nares Spongy cut surface.
All patients were classified radiologically and surgically according to the Fisch system. The tumor invades the nasal sinuses or the pterygomaxillary fossa with bone destruction. None of our patients experienced complications due to embolization. Oronasal fistula a possible complication of preoperative embolization in the management of juvenile nasopharyngeal angiofibroma.