title: Loss of reflex tearing: an expected consequence of juvenile nasopharyngeal angiofibroma.
abstract: OBJECTIVE
  To report the loss of reflex tearing after surgical treatment of juvenile nasopharyngeal angiofibroma (JNA).
  
  
  METHODS
  A retrospective case series of 8 patients with surgical extirpation of JNA from 1995 to 2003 in a major teaching hospital setting was studied for symptomatic xerophthalmia.
  
  
  RESULTS
  One patient was lost to follow-up. Four of the remaining 7 patients reported a dry ipsilateral eye after surgical treatment of JNA.
  
  
  CONCLUSIONS
  The location of the pterygopalatine ganglion and its associated fibers in the pterygopalatine fossa is directly adjacent to the location of origin of JNA. Lacrimal innervation passes through the pterygopalatine ganglion. Given the extensive nature of advanced JNA and mandate for complete surgical excision, lacrimal dysfunction should be considered an expected consequence of surgery.
  
  
  CONCLUSIONS
  The loss of reflex tearing has not been reported as a consequence of JNA or its surgical treatment.
  
  
  METHODS
  C.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Hillel
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Metzinger
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Nemechek
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Nuss
mesh_terms: D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D012021:Reflex, Abnormal; D012189:Retrospective Studies; D014985:Xerophthalmia / Q000209:etiology*