Premium
Juvenile Angiofibromas: Changing Surgical Concept Over the Last 20 Years
Author(s) -
Mann Wolf J.,
Jecker Peter,
Amedee Ronald G.
Publication year - 2004
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 - 10.1097/00005537-200402000-00020
Subject(s) - medicine , angiofibroma , juvenile nasopharyngeal angiofibroma , surgery , craniofacial , degloving , stage (stratigraphy) , retrospective cohort study , lesion , endoscopic endonasal surgery , skull , paleontology , psychiatry , biology
Abstract Objectives: Nasopharyngeal angiofibroma is a rare tumor. Several surgical approaches have been established, including transpalatal, lateral rhinotomy, craniofacial, and midface degloving procedures. More recently, less invasive endonasal approaches have been used. In a retrospective study, we analyzed the outcome of surgical treatment for angiofibroma to determine whether an endonasal approach was as effective as other, more invasive techniques for removing the tumors. Methods: Thirty patients with histologically confirmed angiofibromas were treated by surgical removal at two institutions during a 20‐year period. Tumors were staged according to size and extension on the basis of imaging and surgical findings using the Fisch classification. Specific analysis of the operative approaches and recurrence rate by stage were included. Recurrent or residual disease was handled by surgical excision. Results: The number of patients treated increased during the last 10 years in both institutions, but no major changes in distribution of tumor stages were observed. In the most recent years, the endonasal approach has been favored. All 30 patients remain alive and free of disease. Conclusions: During the last 12 years, we have undergone a marked shift toward endonasal procedures while the tumor stages of the patients treated remained the same. Our results demonstrate that angiofibromas may be managed successfully using less invasive techniques, thereby reducing morbidity, without increasing the chance of recurrence.