Craniofacial resection of advanced juvenile nasopharyngeal angiofibroma.

Publication/Presentation Date

9-1-2002

Abstract

OBJECTIVE: To describe the results of a craniofacial approach to resection of stage IIIB juvenile nasopharyngeal angiofibroma, performed by an integrated skull base surgical team.

DESIGN: A retrospective case-series review was conducted with postoperative follow-up ranging from 28 to 63 months.

SETTING: Operations were performed at a tertiary medical center.

PATIENTS: A referred sample of 5 male patients, ranging in age from 10 to 23 years (mean, 15 years).

INTERVENTIONS: All patients underwent resection of nasopharyngeal angiofibromas with intracranial extension. The procedure involved an infratemporal fossa approach via zygomatic osteotomy and subtemporal craniectomy. Anterior exposure was gained through a standard facial translocation. Dissection of the cavernous carotid artery was required in 3 patients.

MAIN OUTCOME MEASURES: Intraoperative and postoperative morbidity.

RESULTS: The average operating time was 12 hours 47 minutes. Estimated blood loss ranged from 700 to 1750 mL (mean, 1120 mL), with 2 patients requiring intraoperative transfusion. Patients were hospitalized for a mean duration of 5.6 days. Long-term morbidity includes facial dysesthesia, nasal crusting, and malodorous nasal discharge. No patients sustained stroke, oculomotor dysfunction, vision loss, or auditory impairment. At most recent follow-up, which ranges from 28 to 63 months, tumor recurrence has been confirmed in 1 patient.

CONCLUSIONS: A combined craniofacial approach is appropriate for juvenile nasopharyngeal angiofibroma that extends intracranially. Complete tumor removal with acceptable morbidity can be expected.

Volume

128

Issue

9

First Page

1071

Last Page

1078

ISSN

0886-4470

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

12220215

Department(s)

Administration and Leadership

Document Type

Article

Link to Full Text

Share

COinS