Treatment modalities of nasopharyngeal angiofibroma

Year 2008, Volume: 18 Issue: 4, 263 - 267, 30.08.2008

Aylin Fidan Korcum Bülent V. Ağırdır Gamze Aksu Kenan Güney Oktay Dinç

Abstract

Nasopharyngeal angiofibroma is a rare, benign vascular tumor originating from the sphenopalatine foramen. It primarily affects adolescent males. Due to its propensity to locally destructive growth, the tumor may lead to fatal epistaxis, intracranial extension, and life-threatening complications such as intraoperative hemorrhage. Many treatment modalities have been used for the management of nasopharyngeal angiofibroma, but surgery and external beam radiation therapy have proved to be the only effective treatment modalities with acceptable morbidity. While endoscopic surgery provides successful results for early stage tumors, recent technological advances in radiotherapy offer significant advantages in advance and recurrent tumors.

Keywords

Angiofibroma/surgery/radiotherapy, embolization, therapeutic, endoscopy, nasopharyngeal neoplasms

Nazofarenks anjiyofibromlarında tedavi yaklaşımları

Abstract

Nazofarenks anjiyofibromları özellikle ergenlik döne- minde erkeklerde nadiren görülen, sfenopalatin fora- menden köken alan benign, vasküler tümörlerdir. Lokal destrüktif büyüme özelliğinden dolayı ölümcül kanamalara, intrakraniyal uzanıma ve cerrahi sıra- sında kanama gibi yaşamı tehdit eden komplikas- yonlara neden olabilirler. Tedavide çok sayıda yön- teme başvurulmuş olmasına karşın, kabul edilebilir morbiditeleri nedeniyle etkili tedavi yöntemleri olarak sadece cerrahi ve eksternal radyoterapi uygulan- maktadır. Nazofarenks anjiyofibromlarının tedavisin- de erken evrede endoskopik cerrahinin kullanımıyla başarılı sonuçlar alınmakta, ileri evre ve nüks tümör- lerde ise radyoterapideki son teknolojik gelişmeler önemli avantajlar sağlamaktadır

Keywords

Anjiyofibirom/cerrahi/radyoterapi, embolizasyon, terapötik, endoskopi, nazofarengeal neoplaziler.

References

• Bremer JW, Neel HB 3rd, DeSanto LW, Jones GC. Angiofibroma: treatment trends in 150 patients during 40 years. Laryngoscope 1986;96:1321-9.
• Sennes LU, Butugan O, Sanchez TG, Bento RF, Tsuji DH. Juvenile nasopharyngeal angiofibroma: the routes of invasion. Rhinology 2003;41:235-40.
• Pryor SG, Moore EJ, Kasperbauer JL. Endoscopic versus traditional approaches for excision of juvenile nasopharyngeal angiofibroma. Laryngoscope 2005; 115:1201-7.
• Close LG, Schaefer SD, Mickey BE, Manning SC. Surgical management of nasopharyngeal angiofibro- ma involving the cavernous sinus. Arch Otolaryngol Head Neck Surg 1989;115:1091-5.
• Saylam G, Yucel OT, Sungur A, Onerci M. Proliferation, angiogenesis and hormonal markers in juvenile nasopharyngeal angiofibroma. Int J Pediatr Otorhinolaryngol 2006;70:227-34.
• Tyagi I, Syal R, Goyal A. Staging and surgical approach- es in large juvenile angiofibroma - study of 95 cases. Int J Pediatr Otorhinolaryngol 2006;70:1619-27.
• 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.
• Schick B, Kahle G. Radiological findings in angiofi- broma. Acta Radiol 2000;41:585-93.
• Lloyd G, Howard D, Phelps P, Cheesman A. Juvenile angiofibroma: the lessons of 20 years of modern imag- ing. J Laryngol Otol 1999;113:127-34.
• Douglas R, Wormald PJ. Endoscopic surgery for juvenile nasopharyngeal angiofibroma: where are the limits? Curr Opin Otolaryngol Head Neck Surg 2006;14:1-5.
• Mann WJ, Jecker P, Amedee RG. Juvenile angiofibro- mas: changing surgical concept over the last 20 years. Laryngoscope 2004;114:291-3.
• Dubey SP, Molumi CP. Critical look at the surgical approaches of nasopharyngeal angiofibroma excision and “total maxillary swing” as a possible alternative. Ann Otol Rhinol Laryngol 2007;116:723-30.
• Roche PH, Paris J, Regis J, Moulin G, Zanaret M, Thomassin JM, et al. Management of invasive juvenile nasopharyngeal angiofibromas: the role of a multimo- dality approach. Neurosurgery 2007;61:768-77.
• Danesi G, Panizza B, Mazzoni A, Calabrese V. Anterior approaches in juvenile nasopharyngeal angiofibromas with intracranial extension. Otolaryngol Head Neck Surg 2000;122:277-83.
• Hofmann T, Bernal-Sprekelsen M, Koele W, Reittner P, Klein E, Stammberger H. Endoscopic resection of juvenile angiofibromas - long term results. Rhinology 2005;43:282-9.
• Bales C, Kotapka M, Loevner LA, Al-Rawi M, Weinstein G, Hurst R, et al. Craniofacial resection of advanced juvenile nasopharyngeal angiofibroma. Arch Otolaryngol Head Neck Surg 2002;128:1071-8.
• Fagan JJ, Snyderman CH, Carrau RL, Janecka IP. Nasopharyngeal angiofibromas: selecting a surgical approach. Head Neck 1997;19:391-9.
• Hosseini SM, Borghei P, Borghei SH, Ashtiani MT, Shirkhoda A. Angiofibroma: an outcome review of con- ventional surgical approaches. Eur Arch Otorhinolaryngol 2005;262:807-12.
• Carrillo JF, Celis MA, Ramirez-Ortega M, Rivas B, Ochoa FJ. Osteoplastic maxillotomy for treatment of neoplasms of the nasopharynx and infratemporal fossa. Ann Otol Rhinol Laryngol 2005;114:58-64.
• Cansiz H, Guvenc MG, Sekercioglu N. Surgical approaches to juvenile nasopharyngeal angiofibroma. J Craniomaxillofac Surg 2006;34:3-8.
• Tosun F, Ozer C, Gerek M, Yetiser S. Surgical approaches for nasopharyngeal angiofibroma: comparative analy- sis and current trends. J Craniofac Surg 2006;17:15-20.
• Unsal Tuna E, Karaca C, Kaymakçi M, Ozbek C, Ozdem C. Transpalatal approach in juvenile nasopharyngeal angiofibroma. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2007;17:7-12.
• Herman P, Lot G, Chapot R, Salvan D, Huy PT. Long-term follow-up of juvenile nasopharyngeal angiofibromas: analysis of recurrences. Laryngoscope 1999;109:140-7.
• Zhang M, Garvis W, Linder T, Fisch U. Update on the infratemporal fossa approaches to nasopharyngeal angiofibroma. Laryngoscope 1998;108:1717-23.
• Onerci TM, Yucel OT, Ogretmenoglu O. Endoscopic surgery in treatment of juvenile nasopharyngeal angiofi- broma. Int J Pediatr Otorhinolaryngol 2003;67:1219-25.
• Nicolai P, Berlucchi M, Tomenzoli D, Cappiello J, Trimarchi M, Maroldi R, et al. Endoscopic surgery for juvenile angiofibroma: when and how. Laryngoscope 2003;113:775-82.
• Roger G, Tran Ba Huy P, Froehlich P, Van Den Abbeele T, Klossek JM, Serrano E, et al. Exclusively endoscopic removal of juvenile nasopharyngeal angiofibroma: trends and limits. Arch Otolaryngol Head Neck Surg 2002;128:928-35.
• Wormald PJ, Van Hasselt A. Endoscopic removal of juvenile angiofibromas. Otolaryngol Head Neck Surg 2003;129:684-91.
• Mair EA, Battiata A, Casler JD. Endoscopic laser-assist- ed excision of juvenile nasopharyngeal angiofibromas. Arch Otolaryngol Head Neck Surg 2003;129:454-9.
• Khalifa MA. Endonasal endoscopic surgery for nasopha- ryngeal angiofibroma. Otolaryngol Head Neck Surg 2001;124:336-7.
• Briant TD, Fitzpatrick PJ, Berman J. Nasopharyngeal angiofibroma: a twenty year study. Laryngoscope 1978; 88:1247-51.
• Cummings BJ, Blend R, Keane T, Fitzpatrick P, Beale F, Clark R, et al. Primary radiation therapy for juvenile nasopharyngeal angiofibroma. Laryngoscope 1984; 94:1599-605.
• Fields JN, Halverson KJ, Devineni VR, Simpson JR, Perez CA. Juvenile nasopharyngeal angiofibro- ma: efficacy of radiation therapy. Radiology 1990; 176:263-5.
• Reddy KA, Mendenhall WM, Amdur RJ, Stringer SP, Cassisi NJ. Long-term results of radiation thera- py for juvenile nasopharyngeal angiofibroma. Am J Otolaryngol 2001;22:172-5.
• Dare AO, Gibbons KJ, Proulx GM, Fenstermaker RA. Resection followed by radiosurgery for advanced juvenile nasopharyngeal angiofibroma: report of two cases. Neurosurgery 2003;52:1207-11.
• Park CK, Kim DG, Paek SH, Chung HT, Jung HW. Recurrent juvenile nasopharyngeal angiofibroma treated with gamma knife surgery. J Korean Med Sci 2006;21:773-7.
• McAfee WJ, Morris CG, Amdur RJ, Werning JW, Mendenhall WM. Definitive radiotherapy for juve- nile nasopharyngeal angiofibroma. Am J Clin Oncol 2006;29:168-70.
• Beriwal S, Eidelman A, Micaily B. Three-dimensional conformal radiotherapy for treatment of extensive juvenile angiofibroma: report on two cases. ORL J Otorhinolaryngol Relat Spec 2003;65:238-41.
• Onerci M, Gumus K, Cil B, Eldem B. A rare compli- cation of embolization in juvenile nasopharyngeal angiofibroma. Int J Pediatr Otorhinolaryngol 2005; 69:423-8.