Juvenile Nasopharyngeal Angiofibroma: Changing Paradigms in Management
Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males. It is a benign vascular tumor arising from the spheno-palatine foramen. It is best managed surgically at present by endoscopic methods with or without pre-operative embolization. Tumor attributes like...
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doaj-bb306d43711a4eff824b64d6641069582020-11-24T20:42:07ZengThe Association of Otolaryngologists of India, West BengalBengal Journal of Otolaryngology and Head Neck Surgery2395-23932395-24072018-04-012613542146Juvenile Nasopharyngeal Angiofibroma: Changing Paradigms in ManagementVijay Bhalla0Ramakrishnan Narayanaswamy1Dept of ENT Command Hospital(EC) Alipore Road ALIPORE Kolkata-700027Dept of ENT Command Hospital(EC) Alipore Road ALIPORE Kolkata-700027Introduction Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males. It is a benign vascular tumor arising from the spheno-palatine foramen. It is best managed surgically at present by endoscopic methods with or without pre-operative embolization. Tumor attributes like intracranial extent and residual vascularity after embolization need to be assessed pre-operatively before undertaking endoscopic surgery, in order to reduce surgical blood loss and morbidity. Materials and Methods Twenty-three cases of JNA (n=23) were operated endoscopically at a tertiary level military hospital. They were staged with the Snyderman staging system. Demographic variables including stage wise management were brought out with intraoperative time and blood loss recorded for different stages. Results The intraoperative surgical time, intra-operative blood loss and recurrence/residual rates were compared with similar studies in existing literature and correlated well. Conclusion Endoscopic Endonasal approach to JNA is now a well-established technique. With improvements in embolization techniques and better instrumentation like HD camera systems, endo-bipolar cautery, Coblation and endo-liga clips and neuro-navigation, better visualization and better haemostatis can be achieved, resulting in significant reduction in the morbidity and improvement in surgical results.https://bjohns.in/journal/index.php/bjohns/article/view/382AngiofibromaEndoscopic Surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vijay Bhalla Ramakrishnan Narayanaswamy |
spellingShingle |
Vijay Bhalla Ramakrishnan Narayanaswamy Juvenile Nasopharyngeal Angiofibroma: Changing Paradigms in Management Bengal Journal of Otolaryngology and Head Neck Surgery Angiofibroma Endoscopic Surgery |
author_facet |
Vijay Bhalla Ramakrishnan Narayanaswamy |
author_sort |
Vijay Bhalla |
title |
Juvenile Nasopharyngeal Angiofibroma: Changing Paradigms in Management |
title_short |
Juvenile Nasopharyngeal Angiofibroma: Changing Paradigms in Management |
title_full |
Juvenile Nasopharyngeal Angiofibroma: Changing Paradigms in Management |
title_fullStr |
Juvenile Nasopharyngeal Angiofibroma: Changing Paradigms in Management |
title_full_unstemmed |
Juvenile Nasopharyngeal Angiofibroma: Changing Paradigms in Management |
title_sort |
juvenile nasopharyngeal angiofibroma: changing paradigms in management |
publisher |
The Association of Otolaryngologists of India, West Bengal |
series |
Bengal Journal of Otolaryngology and Head Neck Surgery |
issn |
2395-2393 2395-2407 |
publishDate |
2018-04-01 |
description |
Introduction
Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males. It is a benign vascular tumor arising from the spheno-palatine foramen. It is best managed surgically at present by endoscopic methods with or without pre-operative embolization. Tumor attributes like intracranial extent and residual vascularity after embolization need to be assessed pre-operatively before undertaking endoscopic surgery, in order to reduce surgical blood loss and morbidity.
Materials and Methods
Twenty-three cases of JNA (n=23) were operated endoscopically at a tertiary level military hospital. They were staged with the Snyderman staging system. Demographic variables including stage wise management were brought out with intraoperative time and blood loss recorded for different stages.
Results
The intraoperative surgical time, intra-operative blood loss and recurrence/residual rates were compared with similar studies in existing literature and correlated well.
Conclusion
Endoscopic Endonasal approach to JNA is now a well-established technique. With improvements in embolization techniques and better instrumentation like HD camera systems, endo-bipolar cautery, Coblation and endo-liga clips and neuro-navigation, better visualization and better haemostatis can be achieved, resulting in significant reduction in the morbidity and improvement in surgical results. |
topic |
Angiofibroma Endoscopic Surgery |
url |
https://bjohns.in/journal/index.php/bjohns/article/view/382 |
work_keys_str_mv |
AT vijaybhalla juvenilenasopharyngealangiofibromachangingparadigmsinmanagement AT ramakrishnannarayanaswamy juvenilenasopharyngealangiofibromachangingparadigmsinmanagement |
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