A juvenile nasopharyngeal angiofibroma: our 10-year experience in a tertiary centre

Year 2016, Volume: 26 Issue: 3, 135 - 142, 20.07.2016

Bayram Şahin Şenol Çomoğlu Said Sönmez Beldan Polat Kemal Değer

Abstract

Objectives: This study aims to evaluate the demographic characteristics, tumor stage, surgical treatment and recurrence rate among patients operated with a juvenile nasopharyngeal angiofibroma. Patients and Methods: This retrospective study included 45 patients 44 males, 1 female; mean age 21 years, range 9 to 55 years who underwent surgery at Istanbul University, Istanbul Medical Faculty, Department of Otorhinolaryngology clinic between March 2006 and July 2015. The patients were classified according to age, sex, presenting symptom, tumor stage, surgical procedure applied, preoperative embolization, perioperative blood transfusion, complications, and the presence of recurrence. Results: The most common presenting symptoms were epistaxis 78% and nasal obstruction 73% . Preoperative angiography was performed on all patients and embolization was applied in eligible patients 69% . Transnasal endoscopic approach in 31 patients, midfacial degloving in six patients, and lateral rhinotomy approach in three patients were applied. The overall recurrence rate was 31% n=14 . Conclusion: The most important factor in determining the risk of postoperative recurrence is the preoperative tumor stage. Preoperative embolization reduces the amount of perioperative bleeding. Endoscopic transnasal approach decreases the rate of complications and length of hospitalization.

Keywords

Embolization, endoscopic approach, juvenile nasopharyngeal angiofibroma, minimally invasive surgery, outcome

Jüvenil nazofarengeal anjiofibrom: Üçüncü basamak bir merkezdeki 10 yıllık deneyim

Abstract

Amaç: Bu çalışmada jüvenil nazofarengeal anjiofibrom nedeniyle ameliyat edilen hastaların demografik özellikleri, tümör evresi, cerrahi yöntem ve nüks oranları değerlendirildi.Hastalar ve Yöntemler: Bu retrospektif çalışmaya Mart 2006-Temmuz 2015 tarihleri arasında İstanbul Üniversitesi, İstanbul Tıp Fakültesi Kulak Burun Boğaz Hastalıkları kliniğinde ameliyat edilen 45 hasta 44 erkek, 1 kadın; ort. yaş 21 yıl; dağılım 9-55 yıl dahil edildi. Hastalar yaş, cinsiyet, başvuru semptomu, tümörün evresi, uygulanan cerrahi yöntem, ameliyat öncesi embolizasyon, ameliyat sırası kan transfüzyonu, komplikasyonlar ve nüks varlığına göre sınıflandırıldı.Bulgular: En sık başvuru semptomu burun kanaması %78 ve burun tıkanıklığı %73 idi. Hastaların tamamına ameliyat öncesi anjiyografi yapıldı ve uygun olan hastalara %69 embolizasyon uygulandı. Otuz bir hastada transnazal endoskopik yaklaşım, altı hastada midfasiyal degloving ve üç hastada lateral rinotomi yaklaşımı uygulandı. Genel nüks oranı %31 n=14 idi.Sonuç: Ameliyat sonrası nüks riskini belirleyen en önemli faktör, tümörün ameliyat öncesi evresidir. Ameliyat öncesi embolizasyon, ameliyat sırası kanama miktarını azaltmaktadır. Endoskopik transnazal yaklaşım komplikasyon oranını ve hastanede yatış süresini kısaltmaktadır

Keywords

Embolizasyon, endoskopik yaklaşım, jüvenil nazofarengeal anjiofibrom, minimal invaziv cerrahi, sonuç

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