title: Stage III nasopharyngeal angiofibroma: Improving results with endoscopic-assisted midfacial degloving and modification to the Fisch staging system.
abstract: OBJECTIVE
  To study outcomes with endoscopic-assisted midfacial degloving for Fisch stage III nasopharyngeal angiofibroma and propose a new staging system.
  
  
  METHODS
  Retrospective study of patients with Fisch stage III juvenile nasopharyngeal angiofibroma (JNA) including preoperative angiography, intraoperative blood loss and residue/recurrence following surgery.
  
  
  METHODS
  Tertiary care superspecialty referral center.
  
  
  METHODS
  Fifteen consecutive patients with Fisch stage III JNA undergoing operations over a period of 18 months.
  
  
  METHODS
  Preoperative angiography details, intraoperative blood loss, residue/recurrence, complications of surgery.
  
  
  CONCLUSIONS
  Transarterial embolization with particulate agents followed by endoscopic-assisted midfacial degloving provides excellent outcomes with Fisch stage III JNAs. The modified Fisch staging system proposed would allow better preoperative evaluation and comparison of outcomes with different treatment options for stage III JNAs.
authors: Department of Neurosurgery, (Head of Dept: Prof. Sanjay Behari), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, India.
authors: Saurin R
authors: SR
authors: Shah
authors: Department of Neurosurgery, (Head of Dept: Prof. Sanjay Behari), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, India. Electronic address: amitkeshri2000@yahoo.com.
authors: Amit
authors: A
authors: Keshri
authors: Department of Neurosurgery, (Head of Dept: Prof. Sanjay Behari), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, India.
authors: Simple
authors: S
authors: Patadia
authors: Department of Neurosurgery, (Head of Dept: Prof. Sanjay Behari), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, India.
authors: Rabi Narayan
authors: RN
authors: Sahu
authors: Department of Neurosurgery, (Head of Dept: Prof. Sanjay Behari), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, India.
authors: Arun Kumar
authors: AK
authors: Srivastava
authors: Department of Neurosurgery, (Head of Dept: Prof. Sanjay Behari), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, India.
authors: Sanjay
authors: S
authors: Behari
mesh_terms: D000293:Adolescent; D018322:Angiofibroma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000792:Angiography / Q000379:methods; D016063:Blood Loss, Surgical; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D004724:Endoscopy / Q000379:methods*; D005145:Face / Q000601:surgery*; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D011183:Postoperative Complications; D015642:Radiology, Interventional / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011142:Polyvinyl Alcohol
keywords: Angiography; Endoscopic-assisted midfacial degloving; Fisch staging system; Modified Fisch staging system; Nasopharyngeal angiofibroma; Transarterial embolization