title: Juvenile nasopharyngeal angiofibromas: A study of recurrence pattern and role of pre-Operative embolization - 'a decade'S experience'.
abstract: This study is a retrospective analysis of 30 consecutive cases of Juvenile Nasopharyngeal Angiofibroma (JXA) operated at. Department of Head and Neck Surgery, Kidwai Memorial Institute of Oncology Bangalore, India: la tertiary referral centre) after prior emohilization by an interventional neuro-radiologisl (1996-2002). This study discusses critically the planning of surgical approach, based on anatomico-radiological factors and highlights the efficacy of preoperalive embolization in expediting total re moral of the tumor in 25 out of JO cases with advanced stage JNA.
  
  
  OBJECTIVE
  To analyze the utility of pre-operatire embolisation in surgical extirpation of large JNAs; planning of the surgical approaches based on CT topography of the tumor; to study the various complications of embolisation and surgery associated with JXA & lastly to evaluate the puttern and location of recurrent tumor thus correlating with the original topography.
  
  
  METHODS
  Tertiary care cancer referral centre.
  
  
  METHODS
  PATIENTS ranged in age from ')- 24 years. all being males.
  
  
  METHODS
  Majority of them were accessed by transfacial surgical approach(26). and in the recent past via midfacial degloving(4) within 4H hours of angioembolisation.
  
  
  RESULTS
  Complete removal of the tumor was achieved in 25 out of 30 cases with advanced stage JNA.Post surgical CT scans revealed tumor residua in 5 individuals, where the tumor was documented in - the temporal fossa 12), para-cavernous sinus region (I), cavernous sinus! I) and pterygo palatine fossa (I). Only the lesion in pterygopalaline fossa was successfully re-i>xcised & this alongwith the recurrence at para-cavernous & cavernous sinus & another were treated with radiotherapy; the 2 cases in the temporal fossa are under observation. The average blood loss during the procedure was 546.60 ml.
  
  
  CONCLUSIONS
  Today, advances in radiologie imaging-complemented by interventional neuro-radiological expertise in angio-embolisation have expedited complète excision with minimal morbidity and acceptable recurrence rate. This study has justified pre-operative embolisation and M currently the standard of care for advanced JXA.
authors.affiliation: Department of Head and Neck Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: A M
authors.initials: AM
authors.lastname: Shenoy
authors.forename: N
authors.initials: N
authors.lastname: Grover
authors.forename: N
authors.initials: N
authors.lastname: Janardhan
authors.forename: P
authors.initials: P
authors.lastname: Njayakumar
authors.forename: T
authors.initials: T
authors.lastname: Hegde
authors.forename: S
authors.initials: S
authors.lastname: Satish
keywords: Juvenile nasopharyngeal angiofibroma; embolisation; tumor recurrence