Surgical treatment of non-embolized patients with nasoangiofibroma.
Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon tumor of the sphenopalatine foramen. Surgery combined with preoperative embolization has been the treatment of choice for JNA patients without intracranial invasion. This study aims to assess the viability of surgically treating non-embolized patients with JNA (types I-III according to Fisch).


METHODS
This is a retrospective, descriptive study based on the medical records of 15 patients with histologically confirmed JNA (Fisch's types I- III), who underwent surgical treatment without pre-op embolization in our institution between 2000 and 2005.


RESULTS
Seven of the fifteen patients were approached endoscopically, four through the transantral approach, three were treated with the combined transmaxillary and endoscopic approach, and one with the combined transmaxillary and transpalatal approach. Six patients required intraoperatory blood transfusion, averaging volumes of 1.3 unit/patient. There were no cases of death or significant morbidity. Eleven of the fifteen patients were followed for an average of twelve months and 27% of them relapsed. Four patients did not comply with the follow-up scheme.


CONCLUSIONS
Resection of JNF types I-III was safely completed in non-embolized patients. The observed levels of intraoperative bleeding, occurrence of complications, and rates of recurrence were close to those seen in embolized patients as found in the literature.
Fonseca
Adriano Santana
AS
Santa Casa de Misericórdia da Bahia, Hospital Santa Izabel.
Vinhaes
Eriko
E
Boaventura
Viviane
V
Andrade
Nilvano Alves de
NA
Dias
Lislane Andrade
LA
Medeiros
Vyrna
V
Coifman
Fernando
F
D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000601:surgery*; D002648:Child; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016896:Treatment Outcome; D055815:Young Adult