Treatment outcomes of juvenile nasopharyngeal angiofibroma according to surgical approach

Dong Woo Hyun, Ji Hwan Ryu, Yoo Suk Kim, Kyu Bo Kim, Won Shik Kim, Chang-Hoon Kim, Joo Heon Yoon

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: This is a retrospective study to assess treatment outcomes according to stage and surgical approach in advanced juvenile nasopharyngeal angiofibroma (JNA). Methods: We retrospectively evaluated 20 JNA patients diagnosed and treated at our hospital. We only enrolled advanced disease with Radkowski stages greater than I and with minimum follow-up of 1 year (range 1-8.5). Results: Recurrence or remnants were observed in 7 patients out of 20 patients (35.0%) who underwent primary surgical resection of advanced JNA and the mean interval to recurrence was 15.6 months (range 6-38). A recurrence rate according to a different stage was as follows: 33.3% in stage IIa, 33.3% in stage IIb, 50.0% in stage IIc and no recurrence in stage III. An endoscopic approach was chosen in 4 patients among these patients, four were classified as stage IIb tumors, one as a stage IIc tumor, with a recurrence rate of 25.0%, but no recurrence found in stage IIa disease. A midfacial degloving approach was used in 7 patients, with a recurrence rate of 42.9% and maxillary swing approach was taken in 3 patients with complete control. Postoperative complications required interventions occurred in 14.8%, more in the invasive maxillary swing or infratemporal fossa approaches. Conclusions: Although selecting minimal invasive or invasive approaches is equivocal, we recommend using the endoscopic approach or a midfacial degloving approach for the treatment of JNA extended to the pterygopalatine fossa. For stage III, aggressive surgery is preferable to guaranty a complete resection even if postoperative complications are more frequent. For a stage IIc, we could choose between a minimally invasive approach or a more aggressive one balancing between the possibility of salvage surgery in the future and the occurrence of postoperative healing problems.

Original languageEnglish
Pages (from-to)69-73
Number of pages5
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume75
Issue number1
DOIs
Publication statusPublished - 2011 Jan 1

Fingerprint

Angiofibroma
Recurrence
Pterygopalatine Fossa
Neoplasms
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology

Cite this

Hyun, Dong Woo ; Ryu, Ji Hwan ; Kim, Yoo Suk ; Kim, Kyu Bo ; Kim, Won Shik ; Kim, Chang-Hoon ; Yoon, Joo Heon. / Treatment outcomes of juvenile nasopharyngeal angiofibroma according to surgical approach. In: International Journal of Pediatric Otorhinolaryngology. 2011 ; Vol. 75, No. 1. pp. 69-73.
@article{ddbe6a2bd3fc4685836e039c8932cd66,
title = "Treatment outcomes of juvenile nasopharyngeal angiofibroma according to surgical approach",
abstract = "Objective: This is a retrospective study to assess treatment outcomes according to stage and surgical approach in advanced juvenile nasopharyngeal angiofibroma (JNA). Methods: We retrospectively evaluated 20 JNA patients diagnosed and treated at our hospital. We only enrolled advanced disease with Radkowski stages greater than I and with minimum follow-up of 1 year (range 1-8.5). Results: Recurrence or remnants were observed in 7 patients out of 20 patients (35.0{\%}) who underwent primary surgical resection of advanced JNA and the mean interval to recurrence was 15.6 months (range 6-38). A recurrence rate according to a different stage was as follows: 33.3{\%} in stage IIa, 33.3{\%} in stage IIb, 50.0{\%} in stage IIc and no recurrence in stage III. An endoscopic approach was chosen in 4 patients among these patients, four were classified as stage IIb tumors, one as a stage IIc tumor, with a recurrence rate of 25.0{\%}, but no recurrence found in stage IIa disease. A midfacial degloving approach was used in 7 patients, with a recurrence rate of 42.9{\%} and maxillary swing approach was taken in 3 patients with complete control. Postoperative complications required interventions occurred in 14.8{\%}, more in the invasive maxillary swing or infratemporal fossa approaches. Conclusions: Although selecting minimal invasive or invasive approaches is equivocal, we recommend using the endoscopic approach or a midfacial degloving approach for the treatment of JNA extended to the pterygopalatine fossa. For stage III, aggressive surgery is preferable to guaranty a complete resection even if postoperative complications are more frequent. For a stage IIc, we could choose between a minimally invasive approach or a more aggressive one balancing between the possibility of salvage surgery in the future and the occurrence of postoperative healing problems.",
author = "Hyun, {Dong Woo} and Ryu, {Ji Hwan} and Kim, {Yoo Suk} and Kim, {Kyu Bo} and Kim, {Won Shik} and Chang-Hoon Kim and Yoon, {Joo Heon}",
year = "2011",
month = "1",
day = "1",
doi = "10.1016/j.ijporl.2010.10.010",
language = "English",
volume = "75",
pages = "69--73",
journal = "International Journal of Pediatric Otorhinolaryngology",
issn = "0165-5876",
publisher = "Elsevier Ireland Ltd",
number = "1",

}

Treatment outcomes of juvenile nasopharyngeal angiofibroma according to surgical approach. / Hyun, Dong Woo; Ryu, Ji Hwan; Kim, Yoo Suk; Kim, Kyu Bo; Kim, Won Shik; Kim, Chang-Hoon; Yoon, Joo Heon.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 75, No. 1, 01.01.2011, p. 69-73.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Treatment outcomes of juvenile nasopharyngeal angiofibroma according to surgical approach

AU - Hyun, Dong Woo

AU - Ryu, Ji Hwan

AU - Kim, Yoo Suk

AU - Kim, Kyu Bo

AU - Kim, Won Shik

AU - Kim, Chang-Hoon

AU - Yoon, Joo Heon

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Objective: This is a retrospective study to assess treatment outcomes according to stage and surgical approach in advanced juvenile nasopharyngeal angiofibroma (JNA). Methods: We retrospectively evaluated 20 JNA patients diagnosed and treated at our hospital. We only enrolled advanced disease with Radkowski stages greater than I and with minimum follow-up of 1 year (range 1-8.5). Results: Recurrence or remnants were observed in 7 patients out of 20 patients (35.0%) who underwent primary surgical resection of advanced JNA and the mean interval to recurrence was 15.6 months (range 6-38). A recurrence rate according to a different stage was as follows: 33.3% in stage IIa, 33.3% in stage IIb, 50.0% in stage IIc and no recurrence in stage III. An endoscopic approach was chosen in 4 patients among these patients, four were classified as stage IIb tumors, one as a stage IIc tumor, with a recurrence rate of 25.0%, but no recurrence found in stage IIa disease. A midfacial degloving approach was used in 7 patients, with a recurrence rate of 42.9% and maxillary swing approach was taken in 3 patients with complete control. Postoperative complications required interventions occurred in 14.8%, more in the invasive maxillary swing or infratemporal fossa approaches. Conclusions: Although selecting minimal invasive or invasive approaches is equivocal, we recommend using the endoscopic approach or a midfacial degloving approach for the treatment of JNA extended to the pterygopalatine fossa. For stage III, aggressive surgery is preferable to guaranty a complete resection even if postoperative complications are more frequent. For a stage IIc, we could choose between a minimally invasive approach or a more aggressive one balancing between the possibility of salvage surgery in the future and the occurrence of postoperative healing problems.

AB - Objective: This is a retrospective study to assess treatment outcomes according to stage and surgical approach in advanced juvenile nasopharyngeal angiofibroma (JNA). Methods: We retrospectively evaluated 20 JNA patients diagnosed and treated at our hospital. We only enrolled advanced disease with Radkowski stages greater than I and with minimum follow-up of 1 year (range 1-8.5). Results: Recurrence or remnants were observed in 7 patients out of 20 patients (35.0%) who underwent primary surgical resection of advanced JNA and the mean interval to recurrence was 15.6 months (range 6-38). A recurrence rate according to a different stage was as follows: 33.3% in stage IIa, 33.3% in stage IIb, 50.0% in stage IIc and no recurrence in stage III. An endoscopic approach was chosen in 4 patients among these patients, four were classified as stage IIb tumors, one as a stage IIc tumor, with a recurrence rate of 25.0%, but no recurrence found in stage IIa disease. A midfacial degloving approach was used in 7 patients, with a recurrence rate of 42.9% and maxillary swing approach was taken in 3 patients with complete control. Postoperative complications required interventions occurred in 14.8%, more in the invasive maxillary swing or infratemporal fossa approaches. Conclusions: Although selecting minimal invasive or invasive approaches is equivocal, we recommend using the endoscopic approach or a midfacial degloving approach for the treatment of JNA extended to the pterygopalatine fossa. For stage III, aggressive surgery is preferable to guaranty a complete resection even if postoperative complications are more frequent. For a stage IIc, we could choose between a minimally invasive approach or a more aggressive one balancing between the possibility of salvage surgery in the future and the occurrence of postoperative healing problems.

UR - http://www.scopus.com/inward/record.url?scp=78650978839&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650978839&partnerID=8YFLogxK

U2 - 10.1016/j.ijporl.2010.10.010

DO - 10.1016/j.ijporl.2010.10.010

M3 - Article

VL - 75

SP - 69

EP - 73

JO - International Journal of Pediatric Otorhinolaryngology

JF - International Journal of Pediatric Otorhinolaryngology

SN - 0165-5876

IS - 1

ER -