Total Endoscopic or Endoscope-Assisted Excision of Non-embolized Advanced Juvenile Nasopharyngeal Angiofibroma: A Clinical Case Series.
Cureus
; 16(5): e60747, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38903296
ABSTRACT
Background Surgical excision is the primary treatment for juvenile nasopharyngeal angiofibroma (JNA), but this procedure is challenging due to its high vascularity and local aggressiveness. Moreover, preoperative embolization is a subject of debate. Objective The objective of this study is to assess the efficacy, safety, and feasibility of endoscope-assisted excision as a surgical intervention for non-embolized advanced JNA. Materials and methods This case series involved six male patients (mean age 16 years) with JNA, classified as stages â
¡c to â
¢b according to the Radkowski classification. None underwent preoperative embolization. Results Two stage â
¡c cases underwent total endoscopic endonasal excision. One patient with stage â
¢a and another with stage â
¢b underwent surgery via an endoscope-assisted sublabial approach. Two patients, one with stage â
¡c JNA and another with â
¢b, underwent a two-stage procedure. Postoperative CT scans showed no residual disease at the six-month mark. On average, each procedure required 1.5 units of blood transfusion. One patient experienced intraoperative bleeding, whereas the remaining patients were free of any major complications. The mean operation duration was 175 minutes per procedure. The mean length of stay at the hospital was 3.75 days per procedure. Conclusion Endoscope-assisted or purely endoscopic approaches can be safely and effectively employed for the complete excision of non-embolized advanced JNAs.
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MEDLINE
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Ano de publicação:
2024
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Article