Marshall Andrew H, Bradley Patrick J
Department of Otolaryngology, Head and Neck Surgery, Queen's Medical Centre NHS Trust, University Hospital, Nottingham, UK.
ORL J Otorhinolaryngol Relat Spec. 2006;68(5):273-8. doi: 10.1159/000093218. Epub 2006 May 8.
Advanced juvenile nasopharyngeal angiofibroma (JNA) (i.e. disease with intracranial extension) is reportedly uncommon. The optimum management form of such a clinical situation currently remains controversial. This review, of the recent English published literature, discusses the common JNA classification systems advocated, shows the advantages and disadvantages of surgical approaches used (both open, endoscopic or combined), and re-evaluates the current role of radiotherapy (for initial management or treatment of residual/recurrent disease). We also discuss the typical presentation of these patients, the role of pre-operative embolization, as well as surgical techniques to minimize recurrence, and advocate a post-treatment follow-up protocol.
晚期青少年鼻咽血管纤维瘤（JNA）（即伴有颅内侵犯的疾病）据报道并不常见。目前，这种临床情况的最佳治疗方式仍存在争议。这篇对近期英文发表文献的综述，讨论了常用的JNA分类系统，展示了所采用手术方法（开放手术、内镜手术或联合手术）的优缺点，并重新评估了放疗（用于初始治疗或残余/复发性疾病的治疗）的当前作用。我们还讨论了这些患者的典型表现、术前栓塞的作用，以及将复发风险降至最低的手术技术，并倡导一种治疗后随访方案。
