title: Coblation assisted endoscopic juvenile nasopharyngeal angiofibroma resection.
abstract: To provide additional support for the use of coblation in the surgical treatment of juvenile nasopharyngeal angiofibroma (JNA) tumors. Coblation radiofrequency has been recently described in endoscopic sinus surgery for polyp and tumor resection from the sinuses to the skull base. This is a case series from our institution in which we safely and successfully treated three adolescent boys with JNA using the coblation assisted technique. The first case was the smallest of the cases (Radkowski stage IB) and was embolized pre-operatively. The second and third cases, both larger in size (Radkowski stage IIC and IIB) did not undergo pre-operative embolization. The total surgical times were 105, 160, and 150 min and the estimated blood losses were 150, 400, and 130 mL, respectively. This yielded a blood loss per minute rate of only 1.4, 2.5, and 0.9 mL/min for the respective cases. None of the three patients required post-operative blood transfusion, nasal packing, or hospitalization of greater than one day. Follow-up showed no complications and no recurrence in these patients. Coblation assisted transnasal endoscopic resection of JNA is a feasible technique that can dissect through and debulk JNA tumor, despite its extreme vascularity. The surgery can be performed with minimal morbidity and low intraoperative blood loss, even with non-embolized tumors up to Radkowski IIC. These finding further support complete resection of JNA tumors using minimally invasive coblation assisted techniques.
authors.affiliation: University of Miami Center for Sinus and Voice, Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, FL 33136, USA.
authors.forename: Jose W
authors.initials: JW
authors.lastname: Ruiz
authors.forename: Sandra
authors.initials: S
authors.lastname: Saint-Victor
authors.forename: Belachew
authors.initials: B
authors.lastname: Tessema
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
authors.forename: Amy
authors.initials: A
authors.lastname: Anstead
mesh_terms: D055011:Ablation Techniques; D000293:Adolescent; D018322:Angiofibroma / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult