Resection of a juvenile nasoangiofibroma by Le Fort I osteotomy: Experience with 40 cases.
OBJECTIVE
The aim of this study was to determine the rate of success and complications of juvenile nasoangiofibroma resection by Le Fort I osteotomy.


METHODS
Data were obtained from the medical records of 40 patients with a diagnosis of juvenile nasoangiofibroma confirmed by anatomopathological examination. All tumors were resected by Le Fort I osteotomy between 1983 and 2010. The data obtained were gender, age, symptoms, sites of invasion, preoperative embolization, routes of surgical access, duration of surgery, complications, need for transfusion, relapses, and follow-up time.


RESULTS
All patients were male, ranging in age from 7 to 27 years. The most common symptom was nasal obstruction, and central nervous system (CNS) invasion was present in 27.5% of cases. Craniotomy was associated with Le Fort I osteotomy in only one case. The mean duration of surgery was 216 min. Complications occurred in 15% of cases, with intraoperative bleeding being the most frequent one. Relapses occurred in 5% of cases. The mean follow-up was 48.8 months.


CONCLUSIONS
Exclusively surgical treatment by Le Fort I access proved to be a safe and effective method for the treatment of nasoangiofibromas, permitting the removal of tumors even in patients with extension to the CNS, with a low rate of complications and relapses.
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil.
Francisco Veríssimo
FV
de Mello-Filho
University of Santo Amaro (UNISA), São Paulo, Brazil.
Fernando Cesar França
FC
Araujo
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil.
Paulo Barrero
PB
Marques Netto
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil.
Francisco Januário Farias
FJ
Pereira-Filho
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil.
Rodolfo Cardoso
RC
de Toledo-Filho
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil. Electronic address: anacfaria@usp.br.
Ana Célia
AC
Faria
D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000473:pathology / Q000601:surgery*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D016543:Central Nervous System Neoplasms / Q000473:pathology; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008437:Maxilla / Q000601:surgery*; D015508:Nasal Obstruction / Q000473:pathology; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000473:pathology / Q000601:surgery*; D061646:Operative Time; D019340:Osteotomy, Le Fort / Q000379:methods*; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
Juvenile nasopharyngeal angiofibroma; Le Fort I osteotomy; Surgery