Le Fort I osteotomy for extensive juvenile nasopharyngeal angiofibroma: a retrospective study.
BACKGROUND
Juvenile nasopharyngeal angiofibroma (JNA) is a rare, nonencapsulated, benign neoplasm typically diagnosed in adolescent boys. Surgery is the usual treatment modality for JNA. The optimal surgical procedure should allow maximal exposure of the tumor for complete excision with minimum morbidity. One possible surgical approach is Le Fort I maxillary osteotomy. The aim of this study was to review our experience with the Le Fort I osteotomy and to investigate the feasibility of this approach for extensive JNA invaded into pterygopalatine and infratemporal fossae.


METHODS
We retrospectively studied patients who had undergone JNA resection via the Le Fort I osteotomy approach from July 2000 to September 2007, considering tumor location and size, complications, and tumor recurrence associated with the surgical approach.


RESULTS
Six patients of JNA (all boys; mean age, 15.5 years) were identified through the chart review. All the angiofibromas had extended into the pterygomaxillary space and infratemporal fossa. The mean follow-up for this cohort was 50.1 months. No intraoperative and postoperative complications were noted, except for slight diplopia in one patient due to injury of the left medial rectus muscle. There were no cases of tumor recurrence that could be attributed to the procedure.


CONCLUSIONS
Our experience suggests that the Le Fort I osteotomy approach is a useful technique for the removal of extensive JNA invaded into pterygopalatine and infratemporal fossae. It has distinct advantages over traditional anterior or lateral approaches, providing a more direct vision, improved exposure, and cosmesis.
Department of Otorhinolaryngology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China.
Ying
Y
Lin
Jian-Hua
JH
Qiu
Li
L
Qiao
Li-Sheng
LS
He
Ding-Jun
DJ
Zha
D000293:Adolescent; D018322:Angiofibroma / Q000601:surgery*; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000601:surgery*; D019340:Osteotomy, Le Fort / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult