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Treatment outcomes of juvenile nasopharyngeal angiofibroma according to surgical approach.

Authors
 Dong-Woo Hyun  ;  Ji-Hwan Ryu  ;  Yoo-Suk Kim  ;  Kyu-Bo Kim  ;  Won Shik Kim  ;  Chang-Hoon Kim  ;  Joo-Heon Yoon 
Citation
 INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, Vol.75(1) : 69-73, 2011 
Journal Title
 INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY 
ISSN
 0165-5876 
Issue Date
2011
MeSH
Adolescent ; Adult ; Angiofibroma/pathology* ; Angiofibroma/surgery* ; Child ; Cohort Studies ; Endoscopy/methods ; Follow-Up Studies ; Humans ; Male ; Nasopharyngeal Neoplasms/pathology* ; Nasopharyngeal Neoplasms/surgery* ; Neoplasm Invasiveness/pathology ; Neoplasm Recurrence, Local/surgery* ; Neoplasm Staging ; Otorhinolaryngologic Surgical Procedures/methods ; Retrospective Studies ; Risk Assessment ; Treatment Outcome ; Young Adult
Abstract
OBJECTIVE: This is a retrospective study to assess treatment outcomes according to stage and surgical approach in advanced juvenile nasopharyngeal angiofibroma (JNA). METHODS: We retrospectively evaluated 20 JNA patients diagnosed and treated at our hospital. We only enrolled advanced disease with Radkowski stages greater than I and with minimum follow-up of 1 year (range 1-8.5). RESULTS: Recurrence or remnants were observed in 7 patients out of 20 patients (35.0%) who underwent primary surgical resection of advanced JNA and the mean interval to recurrence was 15.6 months (range 6-38). A recurrence rate according to a different stage was as follows: 33.3% in stage IIa, 33.3% in stage IIb, 50.0% in stage IIc and no recurrence in stage III. An endoscopic approach was chosen in 4 patients among these patients, four were classified as stage IIb tumors, one as a stage IIc tumor, with a recurrence rate of 25.0%, but no recurrence found in stage IIa disease. A midfacial degloving approach was used in 7 patients, with a recurrence rate of 42.9% and maxillary swing approach was taken in 3 patients with complete control. Postoperative complications required interventions occurred in 14.8%, more in the invasive maxillary swing or infratemporal fossa approaches. CONCLUSIONS: Although selecting minimal invasive or invasive approaches is equivocal, we recommend using the endoscopic approach or a midfacial degloving approach for the treatment of JNA extended to the pterygopalatine fossa. For stage III, aggressive surgery is preferable to guaranty a complete resection even if postoperative complications are more frequent. For a stage IIc, we could choose between a minimally invasive approach or a more aggressive one balancing between the possibility of salvage surgery in the future and the occurrence of postoperative healing problems
Full Text
http://www.sciencedirect.com/science/article/pii/S0165587610004775
DOI
10.1016/j.ijporl.2010.10.010
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
5. Research Institutes (연구소) > Research Center for Human Natural Defense System (생체방어연구센터) > 1. Journal Papers
Yonsei Authors
Kim, Won Shik(김원식)
Kim, Yoo Suk(김유석)
Kim, Chang Hoon(김창훈) ORCID logo https://orcid.org/0000-0003-1238-6396
Ryu, Ji Hwan(유지환)
Yoon, Joo Heon(윤주헌)
Hyun, Dong Woo(현동우)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93839
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