Preoperatif embolizasyonun juvenil nazofaringeal anjiyofibroma hastalarında ameliyat ve ameliyat sonrası sonuçlarına etkisi

Yıl 2025, Cilt: 50 Sayı: 4, 1175 - 1180, 22.12.2025

Elvan Onan , Çağlar Eker , İlda Tanrısever , Bilen Onan , Muhammed Dağkıran , Özgür Sürmelioğlu , Süleyman Özdemir , Özgür Tarkan , Mete Kıroğlu

https://doi.org/10.17826/cumj.1821266

Öz

Amaç: Bu çalışma, eksternal karotis arter (ECA) ile kombine eksternal ve internal karotis arter (ECA+ICA) beslenmesinin Juvenil nazofaringeal anjiyofibromanın (JNA) cerrahi sonuçları üzerindeki etkisini değerlendirmiştir.
Gereç ve Yöntem: Bu retrospektif gözlemsel çalışma, 2007–2025 yılları arasında endoskopik rezeksiyon öncesinde preoperatif transarteriyel embolizasyon uygulanan juvenil nazofaringeal anjiyofibromlu hastaları içermektedir. Hastalar damar beslenmesine (yalnızca ECA veya ECA+ICA) ve Andrews–Fisch evresine göre sınıflandırıldı. Demografik veriler, intraoperatif kan kaybı ve rezidüel tümör durumu analiz edildi.
Bulgular: Ortalama yaş 17,7 yıldı (9–62). Yaş ve ECA dallanma paternleri gruplar arasında anlamlı farklılık göstermedi. Evre I–II tümörlerin tamamı yalnızca ECA tarafından beslenirken, evre III–IV tümörlerde hem yalnızca ECA hem de ECA+ICA beslenmesi görüldü. Ortalama intraoperatif kan kaybı damar grupları arasında anlamlı farklılık göstermedi), ancak evre III–IV hastalıkta evre I–II’ye kıyasla belirgin şekilde daha yüksekti. Rezidüel tümör yalnızca ECA+ICA beslenmesi olan hastalarda görüldü.
Sonuç: ICA katkısı, ileri evre JNA ve rezidüel tümör riskinin artması ile güçlü şekilde ilişkilidir; ancak intraoperatif kan kaybını anlamlı şekilde artırmamaktadır. Bulgular, tümör evresinin kanama ve tam rezeksiyon başarısının temel belirleyicisi olduğunu göstermektedir.

Anahtar Kelimeler

internal karotis arter , Juvenil Nazofaringeal Anjiyofibroma , preoperatif embolizasyon

Proje Numarası

157- karar 44

Impact of preoperative embolization on operative and postoperative outcomes in juvenile nasopharyngeal angiofibroma patients

Öz

Purpose: This study assessed the influence of external carotid artery (ECA) versus combined ECA and internal carotid artery (ICA) supply on surgical outcomes of Juvenile nasopharyngeal angiofibroma (JNA).
Materials and Methods: This retrospective observational study included patients with juvenile nasopharyngeal angiofibroma who underwent preoperative transarterial embolization followed by endoscopic resection between 2007 and 2025. Patients were stratified by vascular supply (ECA-only vs. ECA+ICA) and Andrews–Fisch stage. Demographic data, intraoperative blood loss, and residual tumor status were retrospectively analyzed.
Results: The mean age was 17.7 years (range 9–62). Age and ECA branching patterns did not differ significantly between groups. All stage I–II tumors were supplied exclusively by the ECA, whereas stage III–IV tumors showed both ECA-only and ECA+ICA supply. Mean intraoperative blood loss did not differ significantly between vascular groups but was markedly higher in stage III–IV disease than in compared with stage I–II. Residual tumor occurred only in patients with ECA+ICA supply.
Conclusion: ICA contribution is strongly associated with advanced-stage JNA and increased risk of residual tumor, although it does not significantly elevate intraoperative blood loss. These findings highlight tumor stage as the main predictor of bleeding and completeness of resection.

Anahtar Kelimeler

internal carotid artery , Juvenile Nasopharyngeal Angiofibroma , Preoperative Embolization

Proje Numarası

157- karar 44

Kaynakça

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