[Pathological features and clinical managements of nasopharyngeal angiofibroma].
OBJECTIVE
To study the pathological features of nasopharyngeal angiofibroma (NA) and the principles for clinical managements.


METHODS
Thirty-five patients with NAs were treated in First Affiliated Hospital of Fujian Medical University from Oct. 1981 to May 2007. The pathological changes, sites of origin, causes of intraoperative bleeding and the experiences of managements were retrospectively analysed. Using Fish stage: 6 cases were in stage I, 8 cases were in stage II, 17 cases were in stage III, 4 cases were stage IV. Two cases via endoscopic surgery, 2 cases via palatal approach, 19 cases via midfacial degloving approach, 9 cases via lateral rhinotomy approach, 3 cases via craniofacial combined approach.


RESULTS
In nasal cavity and paranasal sinus, the tumor was covered by squamous or columnar epithelium. The tumor extensions such as in pterygopalatine fossa and infratemporal fossa were covered by fibrous pseudocapsule. All cases of this series originated in the lateral wall of posterior portion of the nasal cavity. Fifteen of thirty-five cases confidentially originated near sphenopalatine foramen. Large and thick vessels in the pedicle region were the exact sites of serious intraoperative bleeding. Thirty-one cases were totally removed. Four cases were subtotal resected. Visual loss revealed in 6 cases, 4 cases visual acuity improved postoperatively. Three cases revealed postoperative dry eye due to surgical involvement of the sphenopalatine ganglion.


CONCLUSIONS
nasopharyngeal angiofibroma is covered by epithelium or pseudo-capsule, it does not infiltrate the surrounding tissue. Dissecting along the surface of tumor might decrease bleeding and facilitate removal of tumor. An ideal surgical management should be done according to actually size and image examination, to the greatest extent keeping normal facial appearance. Attention should be paid to the complications such as visual loss and dry eye.
Lin
Chang
C
Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
Li
Zhi-chun
ZC
Cheng
Jin-mei
JM
Lin
Gong-biao
GB
Zhou
Ai-dong
AD
Yi
Zi-xiang
ZX
D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000473:pathology* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D012189:Retrospective Studies; D055815:Young Adult