gms | German Medical Science

Juvenile nasopharyngeal angiofibroma is a benign and highly vascular tumor that arises at the level of the tissues within the sphenopalatine foramen. As it grows, the tumor invades the nasal cavities, the rhinopharynx, the paranasal sinuses, pterygopalatine and infratemporal fossae, the orbit and the skull base.

The tumor removal requires a surgical technique, that can be performed using an endoscopic, transpalatin Denker-Rouge, para-lateronasal, infratemporal or transcranian approach.

Symptoms, clinical appearance and an accurate imaging evaluation decide the surgical tehnique. The management involves frequently a multi-disciplinary team: oftalmology and neurosurgery etc.

Material and Method: Here we present the surgical approaches for 39 cases, operated in the University ENT Department from Cluj Napoca, between 1992-2014, 31 cases beeing in stage I or II and 8 cases beeing in stage IIIA.

Staging was based on the classification of Radkowski.

Surgical approaches were as follows: open technique- para-lateronasal – 25 patients, endoscopic – 14 patients

In all cases, temporary pre-operative external carotid artery ligation was performed.

The endoscopic management of juvenile nasopharyngeal angiofibroma was effective in small to medium tumors. It should be the first-choice option for these cases because of the minimal bleeding, better control of procedure shorter duration procedure, and the possibility of complete tumor removal.

Conclusions: The surgical approach should be determined by tumor location and tumor size.

The transnasal endoscopic approach is a minimally invasive procedure which allows the complete resection of the entire tumor with minimal morphological disturbances.

Recurrences required surgery.

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