Juvenile nasopharyngeal angiofibroma stages I and II: a comparative study of surgical approaches.
OBJECTIVE
The aim of this study was to compare different surgical options used for removal of stages I and II juvenile nasopharyngeal angiofibromas (JNAs). Treatment morbidity was evaluated through blood loss, surgery duration, postoperative hospitalization and outcome. Moreover, an effort was made to explore the role and limits of endoscopic surgery.


METHODS
20 male patients (mean age 14.9 years) were treated for JNA using three different surgical approaches in the Department of Otolaryngology of the University of Athens between May 1998 and January 2007. 9 patients were managed using endoscopic approach, while 5 were treated through midfacial degloving. A transpalatal approach was performed in remaining 6 patients. Preoperative angiography with embolization was performed in all 9 patients who underwent endoscopic removal and in 3 patients treated by midfacial degloving technique.


RESULTS
Findings demonstrated that endoscopic approach, assisted by preoperative embolization, lead to less intraoperative blood loss, shorter duration of surgical procedure, shorter length of hospital stay and no complications, compared with the conventional techniques.


CONCLUSIONS
Our data suggest that with proper patient selection, endoscopic resection of stages I and II JNA, when it is performed after embolization of the feeding vessels, is remarkably bloodless and precise and may be preferable to traditional open approaches.
Yiotakis
Ioannis
I
Department of Otolaryngology, University of Athens, "Hippokration" Hospital, Athens, Greece.
Eleftheriadou
Anna
A
Davilis
Dimitrios
D
Giotakis
Evagelos
E
Ferekidou
Eliza
E
Korres
Stavros
S
Kandiloros
Dimitrios
D
D000293:Adolescent; D018322:Angiofibroma / Q000473:pathology / Q000601:surgery*; D016063:Blood Loss, Surgical; D002648:Child; D004621:Embolization, Therapeutic; D004724:Endoscopy; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011300:Preoperative Care; D013997:Time Factors