Association between vascular supply, stage and tumour size of juvenile nasopharyngeal angiofibroma.
Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular tumour seen in adolescent males. To study the vascular pattern of these tumours, we retrospectively reviewed the records of patients with JNA who underwent preoperative angiography. Most (82.2 %) of the 45 patients assessed were Radkowski stage III with a mean size of 5.29 cm. There was a significant association between tumour stage and size (p = 0.029). Ten different vessels were seen to supply these tumours. All tumours had primary supply from the distal third of the ipsilateral internal maxillary artery (IMA). Accessory vessel supply was chiefly from the Vidian branch of internal carotid artery (ICA) (55.6 %). Stage III tumours were supplied by a greater number of feeding vessels than earlier stage tumours (p < 0.01). Larger tumours were more likely to have ICA supply (p = 0.04). Bilateral supply was seen in 48.7 %. However, there was no predominance of bilateral over ipsilateral IMA supply even in advanced stage tumours. One patient in our series was found to have a caroticocavernous fistula. Residual or recurrent tumours were characterized by new vasculature (100 %) and greater accessory supply from the ipsilateral ICA (85.7 %). Our study highlights the fact that surgical planning cannot be dependent on staging alone and should include preoperative assessment of tumour vasculature by angiography.
Department of ENT, Christian Medical College, Vellore, 632004, India.
Raghav
R
Mehan
Department of ENT, Christian Medical College, Vellore, 632004, India. rupavedantam@cmcvellore.ac.in.
V
V
Rupa
Department of ENT, Christian Medical College, Vellore, 632004, India.
Vijay Kumar
VK
Lukka
Department of Radiology, Christian Medical College, Vellore, India.
Munawar
M
Ahmed
Department of Radiology, Christian Medical College, Vellore, India.
Vinu
V
Moses
Department of Radiology, Christian Medical College, Vellore, India.
N K
NK
Shyam Kumar
D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology*; D000792:Angiography; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008438:Maxillary Artery / Q000000981:diagnostic imaging; D009303:Nasopharyngeal Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology*; D009367:Neoplasm Staging; D009880:Ophthalmic Artery; D012189:Retrospective Studies; D013997:Time Factors; D047368:Tumor Burden
Angiography; Juvenile nasopharyngeal angiofibroma; Stage; Vascular supply