title: Overt and occult vidian canal involvement in juvenile angiofibroma and its possible impact on recurrence.
abstract: Postexcision residual disease in the vidian canal is speculated to contribute to recurrence in juvenile angiofibroma.
  
  
  
  We composed a prospective cohort of 16 consecutive patients with juvenile angiofibroma (stages IIA-IIIB). The presurgical vidian canal assessment was done by contrast-enhanced CT (1.2 mm collimation). At surgery after complete tumor excision, the vidian canal tissue was sampled for histology. Postexcision drilling of the vidian canal was done in 8 of 15 patients to remove microscopic residual disease, with a 24 to 48 month follow-up period.
  
  
  
  Presurgical radiology indicated ipsilateral vidian canal enlargement (≥3 mm)/destruction in 13 of 16 patients. Radiologically occult involvement was documented only by histology in another 1 of 16 patients. Postexcision sampling of the vidian canal noted microscopic residual tumor in 3 of 15 patients. No recurrences were noted in 8 cases (0 of 8) with postexcision drilling of the vidian canal and 2 recurrences in 7 cases (2 of 7) with no drilling (p = .20).
  
  
  
  Vidian canal involvement in juvenile angiofibroma is almost universal (14 of 16) and may be occult to CT evaluation. The site may harbor microscopic residual tumor after seemingly complete excision. Surgical attention toward it may reduce recurrences. © 2015 Wiley Periodicals, Inc. Head Neck 38: E421-425, 2016.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi.
authors.forename: Alok
authors.initials: A
authors.lastname: Thakar
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Hota
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi.
authors.forename: Ashu Seth
authors.initials: AS
authors.lastname: Bhalla
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi.
authors.forename: Siddharth Datta
authors.initials: SD
authors.lastname: Gupta
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi.
authors.forename: Chitra
authors.initials: C
authors.lastname: Sarkar
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000473:pathology* / Q000601:surgery; D002648:Child; D006801:Humans; D009303:Nasopharyngeal Neoplasms; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018365:Neoplasm, Residual / Q000473:pathology*; D011446:Prospective Studies; D019291:Skull Base / Q000601:surgery; D055815:Young Adult
keywords: angiofibroma; recurrence; vidian canal