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Do open and endoscopic resection approaches to juvenile nasopharyngeal angiofibroma result in similar blood loss and recurrence rates?
Author(s) -
Dahl John P.,
Zopf David A.,
Parikh Sanjay R.
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25471
Subject(s) - juvenile nasopharyngeal angiofibroma , infratemporal fossa , pterygopalatine fossa , medicine , skull , surgery , angiofibroma , nasal cavity , embolization , cavernous sinus , orbit (dynamics) , radiology , engineering , aerospace engineering
BACKGROUND Juvenile nasopharyngeal angiofibromas (JNAs) are rare, slow-growing tumors of the nasal cavity and skull base that account for approximately 0.5% of all head and neck tumors. This benign, highly vascular tumor is almost exclusively found in adolescent males. JNAs classically present with nasal obstruction and/or recurrent epistaxis. More advanced tumors can present with facial asymmetry, facial swelling, and visual disturbances. Histologically, JNAs are nonencapsulated tumors comprised of an irregular network of blood vessels set in fibroblastic stroma. They are thought to originate from the sphenopalatine foramen and initially grow into the nasal cavity and pterygopalatine fossa. More advanced lesions are locally destructive and can extend into the infratemporal fossa, orbit, and middle cranial fossa. There are a number of staging systems for JNAs based on the size and extent of the tumor; however, there is no current consensus regarding the optimal classification. The treatment of JNAs is surgical excision, often in combination with preoperative angiography and embolization of the vessels supplying the tumor. JNAs were traditionally resected via open surgical approaches; however, with the advancement of endoscopic skull base techniques, an increasing number of these tumors are being removed endoscopically.