title: [Juvenile nasopharyngeal angiofibroma: endoscopic surgery and follow-up results].
abstract: OBJECTIVE
  To present the changes of surgical approaches for the resection of juvenile nasopharyngeal angiofibromas (JNA) and the follow-up results.
  
  
  METHODS
  The clinical records of 59 patients with JNA treated under endoscope between 2002 and 2009 were reviewed retrospectively. The patients were divided into two groups: Group A (Radkowski I a-II b) and Group B (Radkowsik II c-III b). The tumor stages, feeding vessels, operating time, complications and recurrence were observed and recorded.
  
  
  RESULTS
  There were 7 patients with stage I a, 3 patients with stage I b, 5 patients with stage II a, 6 patients with stage II b, 4 patients with stage II c, 23 patients with stage III a, 11 patients with stage III b. The average age at diagnosis in Group A (21 cases) was 23.9 years old. The average operating time was (106.0 +/- 43.7) min. The follow-up ranged from 3 months to 74 months (median 36 months) except for 3 missing cases. The average age at diagnosis in Group B (38 cases) was 16.2 years old and the average operating time was (152.9 +/- 58.0) min. The follow-up ranged from 3 months to 87 months (median 25 months) except for 5 missing cases. During follow-up, 6 patients in group B recurred. Infarction of thalamencephalon happened in 1 patient in group B who recovered totally afterwards. The difference in operating time between two groups was statistically significant (t = -3.232, P = 0.002). The life table was used to evaluate the survival curves and Log-rank test showed that the difference of recurrent time between two groups was statistically significant (P = 0.03).
  
  
  CONCLUSIONS
  The key techniques to remove tumor are bleeding control, drilling-out the bone that tumor invaded. Transpterygoid or posterolateral wall of maxillary sinus approach are recommended for tumors that extend to infratemporal fossa. Small and intermediate-sized JNA which have no deep invasion of skull base (RadkowskiIa-II b) have a low morbidity. JNA at Radkowski stage IIc and above have residual and recurrent risk.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhou
authors.forename: Ting
authors.initials: T
authors.lastname: Cai
authors.forename: Qian
authors.initials: Q
authors.lastname: Huang
authors.forename: Xi-hong
authors.initials: XH
authors.lastname: Liang
authors.forename: Xin
authors.initials: X
authors.lastname: Ni
authors.forename: Yong-xiang
authors.initials: YX
authors.lastname: Wei
authors.forename: Shun-jiu
authors.initials: SJ
authors.lastname: Cui
authors.forename: Luo
authors.initials: L
authors.lastname: Zhang
authors.forename: Tong
authors.initials: T
authors.lastname: Wang
authors.forename: Hua-chao
authors.initials: HC
authors.lastname: Liu
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: De-min
authors.initials: DM
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000473:pathology / Q000601:surgery*; D002648:Child; D004724:Endoscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult