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Nasopharyngeal angiofibromas: Selecting a surgical approach
Author(s) -
Fagan Johannes J.,
Snyderman Carl H.,
Carrau Ricardo L.,
Janecka Ivo P.
Publication year - 1997
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/(sici)1097-0347(199708)19:5<391::aid-hed5>3.0.co;2-v
Subject(s) - computer science , medicine , medical physics
Background A review of 16 juvenile nasopharyngeal angiofibromas, managed at the University of Pittsburgh, is presented. Methods A retrospective chart review was done. Surgical approaches and factors affecting recurrence are analyzed. Results Endoscopic transnasal, transpalatal, medial maxillectomy, facial translocation, and infratemporal fossa approaches, with or without craniotomy, were employed. The 37.5% recurrence rate reflects the advanced stage of the tumors. A major risk factor for recurrence was tumor involvement of the cranial base. Conclusions The surgical approach should be selected according to tumor location and effectiveness of embolization. In young patients, the approach should minimize the potential for facial growth retardation. Tumors confined to the nasopharynx, nasal cavity, and paranasal sinuses may be removed endoscopically. Medial maxillectomy is recommended for tumors that extend to the medial infratemporal fossa or medial cavernous sinus. Significant involvement of the infratemporal fossa, cavernous sinus, or middle cranial fossa requires infratemporal fossa or transfacial approaches.© 1997 John Wiley & Sons, Inc. Head Neck 19 : 391–399, 1997