Transpalatal approach in juvenile nasopharyngeal angiofibroma

Yıl 2007, Cilt: 17 Sayı: 1, 7 - 12, 12.01.2007

Evrim Ünsal Tuna Cihan Karaca Mustafa Kaymakçı Cem Özbek Cafer Özdem

Öz

Objectives: Juvenile nasopharyngeal angiofibroma JNA cases treated with transpalatal approach were evaluated with respect to localization, complications, intraoperative blood loss, recurrence, and prognosis. Patients and Methods: The study included 15 male patients mean age 13 years; range 10 to 16 years treated for JNA. The patients were classified according to the Chandler staging system. Transpalatal surgical excision was performed in 14 patients. Preoperative embolization of the maxillary arteries was performed in three patients. One patient with intracranial extension was treated with radiotherapy. The mean follow-up was 3 years-7 months range 7 months to 7 years . Results: Three patients 20% had Chandler stage II, 11 patients 73% had stage III, and one patient 7% had stage IV disease. The mean intraoperative blood loss was 575 ml in three patients with preoperative embolization, and 1,079 ml in those without embolization. The average intraoperative transfusion requirement was 2.3 units. Recurrences developed in three patients 20% , two of whom were treated by surgery and one by radiotherapy. Conclusion: Transpalatal surgical approach is effective in the treatment of JNAs localized in the nasopharynx, nasal cavity, and sphenoid sinuses, with minimal mortality and morbidity.

Anahtar Kelimeler

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

Juvenil nazofarenks anjiyofibromunda transpalatal yaklaşım

Öz

Amaç: Juvenil nazofarenks anjiyofibromu nedeniyletranspalatal yaklaşım uygulanan olgular tümör yerleşimi, tedavi, komplikasyonlar, ameliyat sırasında kanama, nüks ve prognoz açısından gözden geçirildi.Hastalar ve Yöntemler: Çalışmaya juvenil nazofarenks anjiyofibromu tanısıyla tedavi edilen 15 erkekhasta alındı. HastalarChandler sınıflamasına göre evrelendirildi. Tedavide14 hastaya transpalatal eksizyon yapıldı. Üç hastaya ameliyattan önce maksiller arter embolizasyonuuygulandı. İntrakraniyal uzanım saptanan bir hastaya primer radyoterapi uygulandı. Ortalama takip süresi 3 yıl-7 ay dağılım 7 ay-7 yıl idi. Bulgular: Chandler sınıflamasına göre, üç hastada %20 evre II, 11 hastada %73 evre III, bir hastada %7 evre IV tümör saptandı. Ameliyat sırasında,embolizasyon yapılan üç hastada ortalama 575 mlkanama olurken, embolizasyon yapılmayan 12 hastada ortalama kanama miktarı 1079 ml idi. Ortalama2.3 ünite kan transfüzyonu yapıldı. Üç hastada %20 nüks oluştu, bunların ikisi cerrahi tedavi uygulanan, biri ise radyoterapi uygulanan hastalardı.Sonuçlar: Nazofarenks, nazal kavite ve sfenoid sinüsyerleşimli juvenil nazofarenks anjiyofibromunun tedavisinde transpalatal cerrahi yaklaşımın etkili olduğu,mortalite ve morbiditesinin az olduğu söylenebilir

Anahtar Kelimeler

Anjiyofibrom/cerrahi, embolizasyon, terapötik, nazofarenks neoplazileri/cerrahi.

Kaynakça

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