[Intra- and extracranial nasopharyngeal fibroma. Contribution of imaging and study of local failure. Report on 34 patients].
Thirty-four patients with nasopharyngeal angiofibroma were treated between 1975 and 1990. Lesions were classed according to Sessions' classification. 17 showed intracranial extension. Treatment always associated embolization and surgical excision using a transfacial approach and, if necessary, neurosurgical techniques. A total of 13 patients (38.2%) developed recurrent lesions; these included 3 (17.6%) patients in the extracranial group and 10 (58.8%) patients in the intracranial group. Erosion of the clivus and displacement of the cavernous sinus seem to be 2 factors significantly associated with the development of recurrent lesions. Symptomatic recurrences were managed by surgery. Close clinical and radiological follow-up of patients with asymptomatic recurrent tumor made it possible to observe the stabilization, or even, the regression of the tumor. This study also underlines the importance of modern diagnostic and interventional imaging, which makes it possible to better determine tumor extension and to perform highly selective embolizations. Modern imaging also detects recurrences which once would have remained unknown because of their small size and the absence of symptoms. The techniques of embolization of the tumor branches from the internal and external carotid arteries are explained. Finally, our results are compared to those published in the literature.
Achouche
J
J
Service d'ORL, Hôpital Lariboisière, Paris.
Laccourreye
O
O
de Gaudemar
I
I
George
B
B
Merland
J J
JJ
Tran Ba Huy
P
P
D000293:Adolescent; D000328:Adult; D002648:Child; D003952:Diagnostic Imaging; D004621:Embolization, Therapeutic; D005350:Fibroma / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies
Les fibromes nasopharyngiens intra et extracrâniens. Apport de l'imagerie et étude de l'échec local. A propos de 34 patients.