Extended Transpalatine Approach for Excision of Juvenile Angiofibroma

• Main Authors: Josefino G. Hernandez, Arsenio A. Cabungcal, Ryner Jose D. Carrillo
• Format: Article
• Language: English
• Published: Philippine Society of Otolaryngology-Head and Neck Surgery, Inc. 2015-12-01
• Series: Philippine Journal of Otolaryngology Head and Neck Surgery
• Subjects: juvenile angiofibroma, juvenile nasopharyngeal angiofibroma, transpalatine approach
• Online Access: https://pjohns.pso-hns.org/index.php/pjohns/article/view/343
• ISSN: 1908-4889; 2094-1501

Objective:  To describe the extended transpalatine approach (ETPA) with transection of the ipsilateral greater palatine artery and extension of the ipsilateral retromolar incision and its corresponding surgical outcomes and present it as an option in the excision of juvenile angiofibroma (JA). Methods:  Study Design: Descriptive Case Series Setting: Tertiary Public University Hospital Subjects: 13 JA cases undergoing ETPA Results: Records of JA in a tertiary hospital from 2007 – 2013 were reviewed. Out of 35 JA patients, 13 underwent excision via extended transpalatine approach. Preoperative work-up included CT scan with contrast with or without preoperative embolization. In all patients, the wide field allowed easy tumor excision and facilitated inspection and hemostasis. There was only one recurrence in our series, compared to 1 each for 4 endoscopic and 18 transmaxillary approaches. Not one of the patients developed a fistula or hypernasal speech. All patients had minimal palatal scarring, symmetric alveolar growth and palatal function. Conclusion: The ETPA is a robust technique. It provides good exposure of JA with minimal preoperative requirements and postoperative complications. Keywords: juvenile angiofibroma, juvenile nasopharyngeal angiofibroma, transpalatine approach