Different surgical approaches for juvenile nasopharyngeal angiofibroma and analysis on their efficacy

• Main Authors: GU Xiang, YUAN Kun, GUO Bei, CHEN Wei, YUAN Wei
• Format: Article
• Language: zho
• Published: Editorial Office of Journal of Third Military Medical University 2020-11-01
• Series: Di-san junyi daxue xuebao
• Subjects: nasopharyngeal angiofibroma; nasal endoscopy; surgical approaches; embolization
• Online Access: http://aammt.tmmu.edu.cn/Upload/rhtml/202006207.htm

Objective To investigate how to choose surgical approaches for juvenile nasopharyngeal angiofibroma (JNA) at stages Ⅰ and Ⅱ, and explore the function and limitation of endoscopic surgery. Methods Clinical data of 20 JNA patients undergoing conventional or endoscopic surgeries in the First Affiliated Hospital of the Army Medical University between January 2002 and December 2018 were collected and retrospectively analyzed. Of them, 9 patients (open surgery group) were given conventional open surgeries (including 5 cases of facial degloving approach and 4 cases of transpalatal approach), and the other 11 patients (endoscopy group) were operated with the aid of endoscopy. The choice of surgical methods, intraoperative blood loss, length of hospitalization, incidence of complications and recurrence, and follow-up data were compared between the 2 groups. Results The enrolled patients were all males, at a mean age of 14.6 years, and pathologically diagnosed with NA. The endoscopy group had less intraoperative blood loss (509 vs 1 072 mL), shorter operation time (135 vs 283 min), shorter length of hospital stay (5.5 vs 10.8 d) and lower recurrence rate (0/11 vs 2/9) when compared to the open surgery group. Conclusion Endoscopic surgery is a safe and reliable technique for JNA, with the advantages of milder traumatic injury, less blood loss, lower recurrence, and shorter hospital stay. Endoscopic surgery after embolization is an ideal method for the treatment of small and medium-sized JNA. For the patients with higher stages of JNA, nasal endoscopy combined with external nasal approach may be considered.