Endoscopic versus traditional approaches for excision of juvenile nasopharyngeal angiofibroma.
OBJECTIVE
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.


METHODS
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. > or = 30 patients), shorter length of hospital stay (2 vs. 5 days), and lower rate of recurrence (0% vs. 24%).


CONCLUSIONS
Endoscopic removal of JNA tumor appears to be safe and effective. Recurrence was not appreciably affected by approach.
Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Shepherd G
SG
Pryor
Eric J
EJ
Moore
Jan L
JL
Kasperbauer
D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D000792:Angiography; D002648:Child; D004621:Embolization, Therapeutic / Q000295:instrumentation; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008279:Magnetic Resonance Imaging; D008297:Male; D015508:Nasal Obstruction / Q000175:diagnosis; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013396:Suction; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome