[Transpalatal approach in juvenile nasopharyngeal angiofibroma].
OBJECTIVE
Juvenile nasopharyngeal angiofibroma (JNA) cases treated with transpalatal approach were evaluated with respect to localization, complications, intraoperative blood loss, recurrence, and prognosis.


METHODS
The study included 15 male patients (mean age 13 years; range 10 to 16 years) treated for JNA. The patients were classified according to the Chandler staging system. Transpalatal surgical excision was performed in 14 patients. Preoperative embolization of the maxillary arteries was performed in three patients. One patient with intracranial extension was treated with radiotherapy. The mean follow-up was 3 years and 7 months (range 7 months to 7 years).


RESULTS
Three patients (20%) had Chandler stage II, 11 patients (73%) had stage III, and one patient (7%) had stage IV disease. The mean intraoperative blood loss was 575 ml in three patients with preoperative embolization, and 1,079 ml in those without embolization. The average intraoperative transfusion requirement was 2.3 units. Recurrences developed in three patients (20%), two of whom were treated by surgery and one by radiotherapy.


CONCLUSIONS
Transpalatal surgical approach is effective in the treatment of JNAs localized in the nasopharynx, nasal cavity, and sphenoid sinuses, with minimal mortality and morbidity.
Unsal Tuna
Evrim
E
Department of Otolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey. e_unsal@yahoo.com
Karaca
Cihan
C
Kaymakçi
Mustafa
M
Ozbek
Cem
C
Ozdem
Cafer
C
D000293:Adolescent; D018322:Angiofibroma / Q000473:pathology / Q000601:surgery*; D016063:Blood Loss, Surgical; D002648:Child; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures; D010159:Palate / Q000601:surgery*; D011379:Prognosis; D016896:Treatment Outcome; D014421:Turkey