Surgical management of juvenila nasopharyngeal angiofibroma without angiographic embolization
Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign neoplasm that occurs almost exclusively in the nasopharynx of adolescent males. Surgery remains the primary treatment of choice. JNA has always presented a management challenge to surgeons because of its vascular nature, site of occurrence,...
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iium-36492016-03-10T04:01:31Z http://irep.iium.edu.my/3649/ Surgical management of juvenila nasopharyngeal angiofibroma without angiographic embolization Raja Lope Ahmad, Raja Ahmad Al'konee Wan Leman, Wan Ishlah Ab Rahman, Jamalludin RF Otorhinolaryngology Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign neoplasm that occurs almost exclusively in the nasopharynx of adolescent males. Surgery remains the primary treatment of choice. JNA has always presented a management challenge to surgeons because of its vascular nature, site of occurrence, and local tissue destruction. The surgical approaches are either standard open method which include external or intraoral incisions, or the recent advanced approach, i.e. via using the endonasal endoscope. It is widely accepted that the use of preoperative angiographic embolization reduces the occurrence of intraoperative bleeding and facilitates tumour removal. However, angiographic embolization is not available at all centres. The purpose of this article is to present our experience with five patients diagnosed with JNA who were resected without embolization, using various surgical approaches. Two tumours were removed via endonasal endoscopic surgery. None of the tumours were embolized prior to surgery. We highlight the preoperative evaluation of tumour extent, using both computed tomography (CT) and magnetic resonance angiography, and the importance of temporary clamping of the external carotid artery intraoperatively. Our results suggest that the latter procedure is a safe and effective means of facilitating surgery and reducing intraoperative bleeding. Elsevier 2008-10 Article PeerReviewed application/pdf en http://irep.iium.edu.my/3649/1/PIIS1015958408600810.pdf Raja Lope Ahmad, Raja Ahmad Al'konee and Wan Leman, Wan Ishlah and Ab Rahman, Jamalludin (2008) Surgical management of juvenila nasopharyngeal angiofibroma without angiographic embolization. Asian Journal of Surgery, 31 (4). pp. 174-178. ISSN 1015-9584 http://www.sciencedirect.com/science/article/pii/S1015958408600810 |
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RF Otorhinolaryngology Raja Lope Ahmad, Raja Ahmad Al'konee Wan Leman, Wan Ishlah Ab Rahman, Jamalludin Surgical management of juvenila nasopharyngeal angiofibroma without angiographic embolization |
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Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign neoplasm that occurs almost exclusively in the nasopharynx of adolescent males. Surgery remains the primary treatment of choice. JNA has always presented a management challenge to surgeons because of its vascular nature, site of occurrence, and local tissue destruction. The surgical approaches are either standard open method which include external or intraoral incisions, or the recent advanced approach, i.e. via using the endonasal endoscope. It is widely accepted that the use of preoperative angiographic embolization reduces the occurrence of intraoperative bleeding and facilitates tumour removal. However, angiographic embolization is not available at all centres. The purpose of this article is to present our experience with five patients diagnosed with JNA who were resected without embolization, using various surgical approaches. Two tumours were removed via endonasal endoscopic surgery. None of the tumours were embolized prior to surgery. We highlight the preoperative evaluation of tumour extent, using both computed tomography (CT) and magnetic resonance angiography, and the importance of temporary clamping of the external carotid artery intraoperatively. Our results suggest that the latter procedure is a safe and effective means of facilitating surgery and reducing intraoperative bleeding. |
format |
Article |
author |
Raja Lope Ahmad, Raja Ahmad Al'konee Wan Leman, Wan Ishlah Ab Rahman, Jamalludin |
author_facet |
Raja Lope Ahmad, Raja Ahmad Al'konee Wan Leman, Wan Ishlah Ab Rahman, Jamalludin |
author_sort |
Raja Lope Ahmad, Raja Ahmad Al'konee |
title |
Surgical management of juvenila nasopharyngeal angiofibroma without angiographic embolization |
title_short |
Surgical management of juvenila nasopharyngeal angiofibroma without angiographic embolization |
title_full |
Surgical management of juvenila nasopharyngeal angiofibroma without angiographic embolization |
title_fullStr |
Surgical management of juvenila nasopharyngeal angiofibroma without angiographic embolization |
title_full_unstemmed |
Surgical management of juvenila nasopharyngeal angiofibroma without angiographic embolization |
title_sort |
surgical management of juvenila nasopharyngeal angiofibroma without angiographic embolization |
publisher |
Elsevier |
publishDate |
2008 |
url |
http://irep.iium.edu.my/3649/ http://irep.iium.edu.my/3649/ http://irep.iium.edu.my/3649/1/PIIS1015958408600810.pdf |
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2023-09-18T20:11:33Z |
last_indexed |
2023-09-18T20:11:33Z |
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