Juvenile nasopharyngeal angiofibromas (JNA) are a rare benign but locally aggressive vascular tumor. Epidemiology Juvenile nasopharyngeal angiofibromas. Juvenile angiofibroma (JNA) is a benign tumor that tends to bleed and occurs in the nasopharynx of prepubertal and adolescent males. Home» Acta Otorrinolaringológica Española» Comprar Tratamiento quirúrgico del angiofibroma nasofaríngeo juvenil en pacientes pediátricos.
|Published (Last):||6 July 2015|
|PDF File Size:||16.37 Mb|
|ePub File Size:||1.19 Mb|
|Price:||Free* [*Free Regsitration Required]|
Our patients were classified using the Fisch system, the most juvneil used in most studies Figures 2 and 3. Case 6 Case 6. Variables analyzed included patient age, sex, symptoms, tumor stage, treatment, duration of surgery, volume of intraoperative bleeding, need for nasal packing after surgery, length of hospitalization, immediate and late complications, recurrence, and preoperative embolization and clamping of the external carotid during surgery.
Sanchez de Guzman G. The tumor invades the infratemporal fossa or orbit without intracranial involvement.
Angiofibroma nasofaríngeo juvenil – Wikipedia, la enciclopedia libre
Classification of Fisch Type I: Electron dense granules composed of tightly bound RNA protein complexes Stromal cells are myofibroblasts. Findings are similar to those described above. Seventeen patients required clamping of the external carotids and tumor embolization. To minimize complications, surgery should be performed at centers with extensive experience.
Intraoperative control of bleeding during the resection of nasopharyngeal angiofibromas can be achieved successfully by temporary clamping of the external carotid arteries in the neck Evaluation of the effectiveness of preoperative embolization in surgery for nasopharyngeal angiofibroma.
Laterally, these tumors may extend to and fill the pterygomaxillary fossa, causing the posterior wall of the maxillary sinus to bulge and eroding the pterygoid plate.
Patients were aged years. Sign up for our Email Newsletters. Tumors that further extend into the infratemporal fossa may progress into the orbit, through the inferior orbital fissure and to jufenil base of the skull through the base of the pterygoid process. Tumors may invade the anterior fossa through the ethmoid and sphenoid sinuses, being more frequent in the middle fossa and remaining extradural 8 9 Service chief medical residency in Otorhinolaryngology, Universidade Federal de Sergipe.
Nasal cavity Esthesioneuroblastoma Nasopharynx Nasopharyngeal carcinoma Nasopharyngeal angiofibroma Larynx Laryngeal cancer Laryngeal papillomatosis. If nasopharyngeal angiofibroma is suspected based on physical examination a smooth vascular submucosal mass in the posterior nasal cavity of an adolescent maleimaging studies such as CT or MRI should be performed. The second patient, also with a Fisch I tumor, underwent clamping of the external carotid arteries without embolization.
A biopsy is recommended only in cases of diagnostic uncertainty4. Recent advances in xngiofibroma treatment of juvenile angiofibroma. This relatively low blood loss may be due to the use of surgical endoscopy, providing better control of bleeding than open surgery, with or without endoscopy. Patients undergoing embolization require external carotid clamping due to collateral circulation, which can increase bleeding.
All patients were treated surgically, including 17 who underwent endoscopic surgery. Open in a separate window. Medical treatment and radiation therapy are only of historical interest. Some surgeons, naofarngeo, do not routinely perform embolization preoperatively, finding that embolization is justified only in larger tumors Tumors that further extend into the infratemporal fossa may progress into the orbit, through the inferior orbital fissure and to the base of the skull through the base of the pterygoid process.
Loading Stack – 0 images remaining. All patients were male, and all had symptoms of progressive nasal obstruction and recurrent epistaxis.
Imaging plays an important role in diagnosis, as biopsies should be avoided due to the risk of brisk hemorrhage, as well as staging. Blood loss, which was — mL in a non-embolized patient, was reduced to — mL in embolized patients 31 32 Juvenile nasopharyngeal angiofibromas are benign but highly vascular tumours.
Improvements in surgical techniques are designed to shorten surgical time and thereby reduce patient morbidity. The development of minimally invasive techniques has led to the increased use of endoscopic surgery for the treatment of nasopharyngeal angiofibroma 21making it ideal for tumors confined to the nasopharynx, nasal cavity, and sphenoid sinus with minimal extension into the pterygopalatine fossa 10,12,13,15,18, The second patient, also with a Fisch I tumor, underwent clamping of the external carotid arteries without embolization.
About Blog Go ad-free. Log in Sign up. The volume of intraoperative bleeding has been shown to be similar in patients with and without embolization 34whereas tendency to relapse was greater in patients undergoing embolization.
Evaluation of the effectiveness of preoperative embolization in surgery for nasopharyngeal angiofibroma.
Angiofibroma nasofaríngeo juvenil
All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Non-surgical treatments are available, including the use of hormones estrogen, testosteroneradiation therapy, chemotherapy, and recently, embolization; however, surgery is considered the treatment of choice, with the route depending on the stage of the tumor and the overall condition of the patient 11,12, Intracranial extension can however occur.
Arch Pathol Lab Med ; Several classification methods juvenill been utilized to stage tumors and assist in choosing the appropriate treatment. However, as in any invasive procedure, embolization presents risks that should be fully explained to the angiofigroma The volume of intraoperative bleeding has been shown to be similar in patients with and without embolization 34whereas tendency to relapse was greater in patients undergoing embolization.
Recent advances in the treatment of juvenile angiofibroma.
We also found that patients who underwent clamping of the external carotid artery and embolization showed less intraoperative bleeding than patients who underwent embolization alone. New author database being installed, click here for details.
Surgical approaches for conventional techniques include transpalatal, transmaxillary, lateral rhinotomy, mid-facial degloving, extended sublabial Denker, and Le Fort type I osteotomy 11,13,20, Intraoperative control of bleeding during the resection of nasopharyngeal angiofibromas can be achieved successfully by temporary clamping of the external carotid arteries in the neck Introduction Nasopharyngeal angiofibroma is a histologically and biologically benign tumor with aggressive behavior due to its location and associated symptoms including significant epistaxis and nasal obstruction 1 2 3 4 5.
Although nasal endoscopic agiofibroma is safe, rapid, and effective, studies are needed to assess the importance of preoperative embolization and clamping of nasofarngeoo external carotid artery in reducing intraoperative bleeding. Surgical approaches for jjvenil techniques include transpalatal, transmaxillary, lateral rhinotomy, mid-facial degloving, extended sublabial Denker, and Le Fort type I osteotomy 11 13 20