Resection of juvenile angiofibroma using the Le Fort I approach.
BACKGROUND
Juvenile angiofibroma (JA) is a rare tumor that occurs exclusively in adolescent male patients. The mainstay treatment for JA is complete surgical excision. Acceptable surgical approaches for the resection of JA include transantral, transpalatal, combined, endoscopic, and Le Fort I procedures, among others. Because exposure of the entire extension of the tumor may not possible, the recurrence rates after surgical treatment of JA may be as high as 55%. The purpose of this study was to evaluate the results after using the Le Fort I technique for the resection of JA.


METHODS
We retrospectively studied 19 patients with JA submitted to surgical resection by using the Le Fort I approach from March 1983 to September 2002. Data regarding demographic characteristics, tumor topography, use of embolization, recurrence, and complication of treatment were obtained.


RESULTS
Patient age at the time of diagnosis ranged from 8 to 26 years with a mean age of 16 years. The most common tumor site was the nasopharynx in 100% of the cases, pterygopalatine fossa (95%), nasal cavity (84%), and sphenoid sinus (63%). Angiography and embolization were performed preoperatively in 57% of the patients. The follow-up period ranged from 1 to 19 years (mean, 9.7 years; median, 8.0 years). One patient experienced malocclusion after surgery. However, we did not observe any recurrences during the follow-up period.


CONCLUSIONS
We conclude that the Le Fort I approach is a safe technique that permits the total resection of the JA with a low rate of postoperative complications and a low rate of recurrence.
de Mello-Filho
Francisco Verssimo
FV
Department of Ophthalmology, Otorhinolaryngology-Head and Neck Surgery, University of São Paulo, Ribeirão Preto, Brazil. fdmfilho@fmrp.usp.br
De Freitas
Luiz Carlos Conti
LC
Dos Santos
Antônio Carlos
AC
Martins Mamede
Rui Celso
RC
D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000601:surgery*; D002648:Child; D004621:Embolization, Therapeutic; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000601:surgery*; D019340:Osteotomy, Le Fort; D012189:Retrospective Studies