title: ROLE OF SURGICAL APPROACHES INFLUENCING TUMOUR RECURRENCE IN NASOPHARYNGEAL ANGIOFIBROMA.
abstract: BACKGROUND
  Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon tumour constituting less than 1% of all head & neck tumours. This tumour has an aggressive local behaviour if left untreated. Surgery is the mainstay of treatment with no common consensus on a single approach. Tumour stage and surgical approaches are the major determinants of outcome. The objective of this study was to evaluate the influence of surgical approaches on tumour recurrence in patients with nasopharyngeal angiofibroma.
  
  
  METHODS
  This descriptive study was conducted in the Department of ENT and Head and Neck Surgery, PIMS, Islamabad and Ayub Medical Institution, Abbottabad from Jan 2010 to Jan 2014 consisting of 34 diagnosed cases of nasopharyngeal angiofibroma. All patients were treated surgically while radiotherapy was given in a few. All patients were followed up for one year.
  
  
  RESULTS
  Among 34 patients, 25 were treated by lateral rhinotomy approach with medial maxillectomy, 5 by mid-facial degloving approach and 3 by transpalatine approach. One patient with cavernous sinus involvement was treated by radiotherapy. Patients were followed up for one year both by clinical examination and imaging if needed. Recurrence was found in 15% (5/33) patients and postop radiotherapy was given to them.
  
  
  CONCLUSIONS
  Lateral rhinotomy approach with medial maxillectomy is highly effective even in advanced stage JNA for complete removal of the disease. Postoperative radiotherapy is an effective adjuvant.
authors.forename: Raza
authors.initials: R
authors.lastname: Muhammad
authors.forename: Altaf
authors.initials: A
authors.lastname: Hussain
authors.forename: Fazal
authors.initials: F
authors.lastname: Rehman
authors.forename: Johar
authors.initials: J
authors.lastname: Iqbal
authors.forename: Munib
authors.initials: M
authors.lastname: Khan
authors.forename: Gohar
authors.initials: G
authors.lastname: Ullah
authors.forename: Zakir
authors.initials: Z
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D018322:Angiofibroma / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D004724:Endoscopy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology*; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010154:Pakistan / Q000453:epidemiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult