Orbital involvement in juvenile nasopharyngeal angiofibroma: prevalence and treatment.
OBJECTIVE
To assess the prevalence of orbital invasion by juvenile nasoangiofibroma and to discuss its surgical treatment.


METHODS
A retrospective review of the medical records and tomographic scans of a case series of 19 patients with juvenile nasoangiofibroma was performed. All scans were reviewed by a radiologist and an orbital surgeon. The presence of the tumor was assessed in the pterygopalatine fossa, nasal cavity, nasopharynx, paranasal sinuses, inferior orbital fissure, orbit, and middle cranial fossa.


RESULTS
The most common structures invaded were pterygopalatine fossa (100%), nasal cavity (94.7%), sphenoid sinus (84.2%), and nasopharynx (73.7%). The orbit was invaded in 6 (31.6%) patients. In 5 of these patients, the tumor extended in the orbit through the inferior orbital fissure. Four patients with orbital invasion were successfully operated with the Le Fort I approach.


CONCLUSIONS
Orbital involvement is relatively common in the setting of juvenile nasoangiofibroma extension. The main route of orbital invasion is the inferior orbital fissure. The Le Fort I osteotomy is an adequate approach for managing juvenile nasoangiofibroma when it invades the orbit.
Cruz
Antonio A V
AA
Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Av.Bandeirantes 3900, Ribeirão Preto, São Paulo, Brazil. aavecruz@fmrp.usp.br
Atique
João M C
JM
Melo-Filho
Francisco V
FV
Elias
Jorge
J
D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D002648:Child; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D009361:Neoplasm Invasiveness; D009918:Orbital Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D019340:Osteotomy, Le Fort / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed