title: Recurrent and residual juvenile angiofibromas.
abstract: BACKGROUND
  In the surgical management of juvenile nasopharyngeal angiofibromas the possibility of recurrences and residual tumours is always there. This study was undertaken to predict the prognostic factors determining recurrence of juvenile nasopharyngeal angiofibroma and to find out the usual sites of these tumours.
  
  
  METHODS
  The medical records of 95 patients with histologically proven juvenile nasopharyngeal angiofibroma were reviewed retrospectively. The commonest surgical approach used was a combined transpalatal and transmaxillary approach with a lazy S incision. A conservative lateral infratemporal approach was used in three cases.
  
  
  RESULTS
  Complete removal of the juvenile nasopharyngeal angiofibroma was achieved in 78 (82 per cent) of the cases in a single operation. A residual tumour was found in 17 (18 per cent) cases and recurrences occurred in 13 (13.7 per cent) cases.
  
  
  CONCLUSIONS
  Extensions into the pterygoid fossa and basisphenoid, erosion of the clivus, intracranial extensions medial to the cavernous sinus, invasion of the sphenoid diploe through a widened pterygoid canal, feeders from the internal carotid artery, a young age and a residual tumour were risk factors found associated with recurrence of juvenile nasopharyngeal angiofibroma.
authors.affiliation: Neuro-otology Unit, Department of Neuro-surgery, Sarjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: I
authors.initials: I
authors.lastname: Tyagi
authors.forename: R
authors.initials: R
authors.lastname: Syal
authors.forename: A
authors.initials: A
authors.lastname: Goyal
mesh_terms: D018322:Angiofibroma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual / Q000175:diagnosis; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed