Endoscopic Excision of Juvenile Nasopharyngeal Angiofibroma: Case Series of 20 Patients

Main Article Content

Monil Parsana
Kalpesh Patel
Abhishek Gugliani

Abstract

Introduction


Juvenile Nasopharyngeal Angiofibroma (JNA) is a highly vascular, benign, locally aggressive tumour of the nasopharynx. Endoscopic approach is the current accepted modality for the excision of Juvenile Nasopharyngeal Angiofibroma. The current study was undertaken to assess the outcome of this procedure at our institute.


Materials and Methods


A total of 20 patients of JNA at a medical college in Ahmedabad between the period of July 2015 to July 2017 were included. The tumour was staged according to Fisch system and clinical presentation, local examination, nasal endoscopy findings, radiological findings, approach of surgical resection, complications and recurrence were noted.


Results 


We found that endoscopic approach for the excision of juvenile nasopharyngeal angiofibroma is safe and effective technique associated with reduced post operative morbidity and low recurrence rates. 


Conclusions 


JNA is a rare but a potentially life-threatening disease. All young males presenting with profuse, spontaneous and recurrent epistaxis should be evaluated for JNA. Endoscopic approaches have become the procedure of choice for resection of these tumours.

Article Details

How to Cite
1.
Parsana M, Patel K, Gugliani A. Endoscopic Excision of Juvenile Nasopharyngeal Angiofibroma: Case Series of 20 Patients. BJOHNS [Internet]. 2020Apr.30 [cited 2024Dec.22];28(1):76-9. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/177
Section
Case series
Author Biographies

Monil Parsana, B.J Medical College and Civil Hospital, Ahmedabad, Gujarat

Resident,
Department of E.N.T

Kalpesh Patel, B.J Medical College and Civil Hospital, Ahmedabad, Gujarat

Associate Professor,
Department of ENT

Abhishek Gugliani, B.J Medical College and Civil Hospital, Ahmedabad, Gujarat

Resident,
Department of ENT

References

Chandler JR, Goulding R, Moskowitz L, Quencer RM. Nasopharyngeal angiofibromas: Staging and management. Ann Otol Rhinol Laryngol. 1984; 93:322-9

El Sharkawy AA, Elmorsy SM. Transnasal endoscopic management of recurrent juvenile nasopharyngeal angiofibroma. Int J Pediatr Otorhinolaryngol. 2011; 75:620-3

Blount A, Riley KO, Woodworth BA. Juvenile nasopharyngeal angiofibroma. Otolaryngol Clin North Am. 2011; 44:989-1004

Marshall AH, Bradley PJ. Management dilemmas in the treatment and follow-up of advanced juvenile nasopharyngeal angiofibroma. ORL J Otorhinolaryngol Relat Spec. 2006; 68:273-8

Douglas R, Wormald PJ. Endoscopic surgery for juvenile nasopharyngeal angiofibroma: where are the limits? Curr Opin Otolaryngol Head Neck Surg. 2006; 14:1-5

Ghosh B, Saha S, Chandra S, Nandi TK, Bera SP. Juvenile nasopharyngeal angiofibroma-three years experience. Indian J Otolaryngol Head Neck Surg. 2003; 55(4):228-33. doi:10.1007/BF02992425.

Mistry RC, Qureshi SS, Gupta S, Gupta S. Juvenile nasopharyngeal angiofibroma: A single institution study. Indian J Cancer 2005;42:35-9

Jacobsson M., Petruson B., Svendsen B., et al. Juvenile nasopharyngeal angiofibroma:A report of eight cases. Acta Otolaryngol. 1988; 105:132-9

Gruber B, Kron TK, Goldman ME, Matz G. Nasopharyngeal angiofibroma in two young children. Otolaryngol Head Surg. 1985; 93 (6): 803

Maroldi R, Nicolai P. Imaging in Treatment Planning for Sinonasal Diseases, Springer, New York, NY, USA, 2004

Lloyd G, Howard D, Lund VJ, Savy L. Imaging for juvenile angiofibroma. J Laryngol Otol. 2000; 114(9):727-30

Schick B, Kahle G. Radiological findings in angiofibroma. Acta Radiologica 2000; 41(6):585-93

Behman A, Regauer S, Behman-Schmid C, Kainz J, Stammberger H. Expression of CD34-antigen in nasopharyngeal angiofibroma. Int J Pediatr Otorhinolaryngol. 1998; 44:245-50

Stansbie JM, Phelps PD. Involution of residual juvenile nasopharyngeal angiofibroma. J Laryngol Otol. 1986; 100:599-603

Hofmann T, Bernal-Sprekelsen M, Köele W, Reittner P, Klein E, Stammberger H. Endoscopic resection of juvenile angiofibromas--long term results. Rhinology 2005; 43(4): 282-9

Anderhuber W, Stammberger H, Watch Ch, Fock CH, Regauer S, Luxenberger W, Gotschuli A. Rigid endoscopy in minimally invasive therapy of tumors of the paranasal sinuses and skull base. Min Invas Ther & Allied Technol. 1999; 8:25-32

Jacobsson M, Petruson B, Svendsen P, Berthelsen B. Juvenile nasopharyngeal angiofibroma: A report of eight cases. Acta Otolaryngol. 1988; 105:132-9.