Deschler D G, Kaplan M J, Boles R
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco 94143.
Otolaryngol Head Neck Surg. 1992 Mar;106(3):278-84. doi: 10.1177/019459989210600315.
The management of large juvenile nasopharyngeal angiofibromas with intracranial extension is controversial. We review our experience since 1980 with eighteen patients with juvenile nasopharyngeal angiofibroma. A diagnostic and treatment approach consisting of preoperative magnetic resonance imaging, embolization of feeding branches from the external carotid artery, and attempted complete resection was used in seven patients with intracranial disease since 1987. Serial magnetic resonance images were used for followup. Intracranial disease that was persistent or recurrent and demonstrated subsequent growth was irradiated (35 to 45 cGy). Extracranial tumor recurrences were reexcised. We advocate this approach as a safe and effective alternative to primary irradiation and its sequelae.
伴有颅内侵犯的大型青少年鼻咽血管纤维瘤的治疗存在争议。我们回顾了自1980年以来收治的18例青少年鼻咽血管纤维瘤患者的治疗经验。自1987年起，7例患有颅内病变的患者采用了包括术前磁共振成像、颈外动脉供血分支栓塞以及尝试完整切除的诊断和治疗方法。采用系列磁共振成像进行随访。对持续存在或复发且有后续生长的颅内病变进行放射治疗（35至45 cGy）。对颅外肿瘤复发进行再次切除。我们主张将这种方法作为原发性放射治疗及其后遗症的一种安全有效的替代方法。
