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Endoscopic versus Traditional Approaches for Excision of Juvenile Nasopharyngeal Angiofibroma
Author(s) -
Pryor Shepherd G.,
Moore Eric J.,
Kasperbauer Jan L.
Publication year - 2005
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 - 10.1097/01.mlg.0000162655.96247.66
Subject(s) - juvenile nasopharyngeal angiofibroma , medicine , surgery , medical record , retrospective cohort study , blood loss , endoscopy , angiofibroma
Objectives: Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon neoplasm originating in the nasopharynx. The purpose of this study was to determine whether endoscopic approaches had been effective without increasing intraoperative blood loss, length of hospital stay, complications, and rate of recurrence as compared with traditional surgical approaches. Study Design: Retrospective chart review to compare outcomes in six consecutive patients who underwent endoscopic resection with outcomes of traditional external excision of JNA at Mayo Clinic between 1975 and 2004. Methods: The medical records of patients who underwent either endoscopic or external surgical resection of JNA were reviewed retrospectively. The main outcome measures were intraoperative blood loss, length of hospital stay, complications, and recurrence. We review the reasons why we developed our current endoscopic approach to resection and highlight some of the obstacles we have encountered. Results: We identified 65 patients treated for JNA during the studied interval. Their mean age was 15 (range 6–35) years. Six consecutive patients underwent successful resection of JNA by way of an endoscopic approach since 2001. Compared with the conventional surgery group, the endoscopic group had less intraoperative blood loss (225 vs. 1,250 mL), a lower occurrence of complications (1 patient vs. ≥ 30 patients), shorter length of hospital stay (2 vs. 5 days), and lower rate of recurrence (0% vs. 24%). Conclusion: Endoscopic removal of JNA tumor appears to be safe and effective. Recurrence was not appreciably affected by approach.