Comparative Study between Conventional Method and Endonasal Endoscopic Resection of Juvenile Nasopharyngeal Angiofibroma.

ABSTRACT

Juvenile Nasopharyngeal Angiofibroma (JNA) is an uncommon, benign and extremely vascular tumour which accounts for 0.05-0.5% of all head and neck tumours. Now a day, endoscopic excision is a preferred surgery for early cases. This study was done with the aim to compare the outcomes and complications between endoscopic and conventional surgery of JNA. This cross sectional observational study was conducted in the Department of Otolaryngology & Head-Neck Surgery at Mymensingh Medical College Hospital, Mymensingh and Bangabandhu Sheikh Mujib Medical University, Dhaka from 8 March 2014 to 7 March, 2015. A total number of 20 cases were purposively selected and patient with intracranial extension were excluded from the study. Data was analyzed with SPSS software. Among the 20 patients, maximum 18(90%) were in 2nd decade, age was ranging from 11-33 years, mean 16.17 years. Maximum patients 13(65%) came with nasal obstruction and epistaxis and majority 13(65%) of them were in stage II. Endoscopic excision was done in 12(60%) cases and conventional surgery was done in 7(35%) cases. Mean hospital stay of endoscopic and conventional group was 4.62 vs. 10.23 days. Mean blood loss and mean operative time were 528.12ml vs. 1050ml and 2 hours 17 minutes vs. 3 hours 28 minutes respectively. Per-operative and postoperative complication were more (53.85%) in conventional surgery group. Endoscopic excision of nasopharyngeal angiofibroma is more preferable due to less operative time, less hospital stay, less per-operative blood loss and less complications. But in advanced cases conventional surgery and combined surgery is preferred.