Giavroglou C, Constantinidis J, Triaridis S, Daniilidis J, Dimitriadis A
Radiologisches Institut der Aristoteles-Universität Thessaloniki, AHEPA-Hospital, Griechenland.
HNO. 2007 Jan;55(1):36-41. doi: 10.1007/s00106-006-1410-y.
In juvenile nasopharyngeal angiofibroma (JNA), analysis of tumor extension and blood supply is useful for controlling intraoperative bleeding and helps in determining the appropriate surgical approach. The purpose of this study was to evaluate angiographic findings and the efficacy and benefits of preoperative embolization of JNA.
Twenty-one male patients with JNA (mean age 13.3 years) were included in this study. The tumors were embolized with particles of gel foam. Surgical removal was achieved through transantral approach (n=2), lateral rhinotomy (n=13), midfacial degloving (n=4), and endonasally (n=2).
The blood supply was exclusively homolateral in 18 patients, deriving mainly from the external carotid artery, and bilateral in three. There were no connections between the branches of the internal and external carotid arteries. Intratumoral embolization was achieved in all patients. No major complications occurred. Mean blood loss during surgery was 560 ml. The recurrence rate was 14%.
Preoperative angiographic evaluation and embolization of JNA are important tools for planning surgical approach. Embolization reduces significantly the intraoperative blood loss, minimizes the need of blood transfusion, and makes resection easier.
在青少年鼻咽血管纤维瘤（JNA）中，分析肿瘤扩展和血供情况有助于控制术中出血，并有助于确定合适的手术入路。本研究的目的是评估JNA的血管造影表现以及术前栓塞的疗效和益处。
本研究纳入了21例男性JNA患者（平均年龄13.3岁）。用明胶海绵颗粒对肿瘤进行栓塞。通过经鼻窦入路（n = 2）、鼻侧切开术（n = 13）、面中部掀翻术（n = 4）和经鼻内入路（n = 2）实现手术切除。
18例患者的血供仅来自同侧，主要来自颈外动脉，3例为双侧。颈内动脉和颈外动脉分支之间无交通。所有患者均实现了瘤内栓塞。未发生重大并发症。手术期间平均失血量为560毫升。复发率为14%。
JNA的术前血管造影评估和栓塞是规划手术入路的重要工具。栓塞可显著减少术中失血量，减少输血需求，并使切除更容易。
