Surgical management of juvenile 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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Main Authors:	Raja Lope Ahmad, Raja Ahmad Al'konee, Wan Leman, Wan Ishlah, Kamarudin, Norie Azilah, Ab Rahman, Jamalludin
Format:	Article
Language:	English
Published:	Elsevier 2008
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/3694/ http://irep.iium.edu.my/3694/1/PIIS1015958408600810.pdf

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spelling	iium-36942016-03-10T06:48:41Z http://irep.iium.edu.my/3694/ Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization Raja Lope Ahmad, Raja Ahmad Al'konee Wan Leman, Wan Ishlah Kamarudin, Norie Azilah Ab Rahman, Jamalludin R Medicine (General) 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 Article PeerReviewed application/pdf en http://irep.iium.edu.my/3694/1/PIIS1015958408600810.pdf Raja Lope Ahmad, Raja Ahmad Al'konee and Wan Leman, Wan Ishlah and Kamarudin, Norie Azilah and Ab Rahman, Jamalludin (2008) Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization. Asian Journal of Surgery, 31 (4). pp. 174-178. ISSN 1015-9584
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Raja Lope Ahmad, Raja Ahmad Al'konee Wan Leman, Wan Ishlah Kamarudin, Norie Azilah Ab Rahman, Jamalludin Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization
description	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 Kamarudin, Norie Azilah Ab Rahman, Jamalludin
author_facet	Raja Lope Ahmad, Raja Ahmad Al'konee Wan Leman, Wan Ishlah Kamarudin, Norie Azilah Ab Rahman, Jamalludin
author_sort	Raja Lope Ahmad, Raja Ahmad Al'konee
title	Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization
title_short	Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization
title_full	Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization
title_fullStr	Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization
title_full_unstemmed	Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization
title_sort	surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization
publisher	Elsevier
publishDate	2008
url	http://irep.iium.edu.my/3694/ http://irep.iium.edu.my/3694/1/PIIS1015958408600810.pdf
first_indexed	2023-09-18T20:11:37Z
last_indexed	2023-09-18T20:11:37Z
_version_	1777407515710980096

Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization

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