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Multimodality approach for advanced‐stage juvenile nasopharyngeal angiofibromas
Author(s) -
Álvarez Fernando López,
Suárez Vanessa,
Suárez Carlos,
Llorente José L.
Publication year - 2013
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/hed.22947
Subject(s) - medicine , radiosurgery , asymptomatic , stage (stratigraphy) , surgery , radiology , radiation therapy , paleontology , biology
Abstract Background Juvenile nasopharyngeal angiofibromas (JNAs) with significant skull base involvement and intracranial extension are challenging tumors. We evaluated our experience in the treatment of extensive JNAs through resection followed by radiosurgery. Methods From 1999 to 2007, 10 advanced JNAs (Andrews grade IV) were treated by primary surgical resection followed by gamma knife radiosurgery of residual tumor. Tumor control and treatment morbidity were evaluated. Results Six months after radiosurgery and annually thereafter, an imaging study was done that revealed decrement in tumor size in 3 patients and no change in 7 patients, after a 3‐year minimum follow‐up. Clinically, patients are asymptomatic. Conclusion An efficient strategy in the management of extensive JNAs is the use of a multimodality approach, in which surgical resection is followed by the treatment with radiosurgery in critical locations. These therapeutic schemes are safe and offer long‐term tumor control. © 2012 Wiley Periodicals, Inc. Head Neck, 2013