Juvenile nasopharyngeal angiofibroma: a single institution study.
BACKGROUND
Juvenile nasopharyngeal angiofibroma (JNA) is a rare tumor of adolescent males and there is a paucity of Indian studies on this subject.


OBJECTIVE
To present the experience of management of JNA at a single institution.


METHODS
This is a retrospective observational study of patients with JNA who presented at the Tata Memorial Hospital between May 1988 and August 2001.


METHODS
Thirty-two patients with JNA were treated in the study period. Since the time period was prolonged and diagnostic and therapeutic protocols had undergone many changes, the patients were divided into two groups, namely 1988-1996 and 1997-2001. The age distribution, disease patterns, management approaches and treatment outcomes of patients in the two groups were recorded. Statistical analyses were done using students 't' test and test for proportion.


RESULTS
The mean age at presentation was 16 years and more than 90% of the patients had Stage III or IV disease. Preoperative embolization was carried out in 19 patients. The surgical approaches used were median maxillectomy, infratemporal fossa, transpalatal, maxillary swing and craniofacial approach. The recurrence rate, complete resection rate and cure rates were 12.5%, 41% and 63% respectively.


CONCLUSIONS
Surgery is the mainstay of treatment of JNA. Preoperative embolization and newer surgical approaches result in less blood loss and complete resection. Aggressive re-resection should be done for resectable recurrences reserving radiotherapy for unresectable, recurrent/ residual disease.
Mistry
Rajesh C
RC
Department of Head and Neck services, Tata Memorial Hospital, Ernest Borges Road, Parel, Mumbai, India. musica@vsnl.com
Qureshi
Sajid S
SS
Gupta
Shaikat
S
Gupta
Sameer
S
D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures / Q000706:statistics & numerical data; D011183:Postoperative Complications; D012189:Retrospective Studies