Zhang Xiang-min, Teng Yi-shu, Wen Wei-ping, Cai Qian, Wang De-le
Hospital of Otorhinolaryngology, The First Affiliated Hospital of SUN Yat-Sen University, Otorhinolaryngology, Institute of Sun Yat-sen University, Guangzhou 510080, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2006 Aug;41(8):579-82.
To investigate the efficacy and the surgical techniques of transnasal endoscopic procedure for juvenile nasopharyngeal angiofibroma (JNA).
Twenty-one nasopharyngeal angiofibroma patients were treated using transnasal endoscopic approach. They were divided into group A (without intracranial extension) and group B (minimal intracranial extension) according to the staging of Sessions. The patients were treated mostly with endoscopic surgery. In two midfacial operations cases, endoscopy was also used. The staging, average blood loss during surgery, tumor residual, and (or) recurrent tumor were evaluated.
Group A (19 cases) had an average blood loss of 1000 ml. Nineteen patients had no residual or recurrent tumor over a follow-up of 8-24 months. Group B (2 cases) had an average blood loss of 1500 ml. One of the patients had minimal residual tumor around the cavernous sinus, but showed no progression over a follow-up of 2 years. Another patient had no residual or recurrent tumor over a follow-up of 8 months.
The data suggests that transnasal endoscopic surgical techniques can be used to treat JNA which either limited to nasal and nasopharyngeal cavities or and the tumor with sphenoid and ethmoid invasions and even minimal intracranial extension.
探讨经鼻内镜手术治疗青少年鼻咽血管纤维瘤（JNA）的疗效及手术技巧。
采用经鼻内镜入路治疗21例鼻咽血管纤维瘤患者。根据Sessions分期将患者分为A组（无颅内侵犯）和B组（轻度颅内侵犯）。患者主要接受内镜手术治疗。在2例面中部手术病例中，也使用了内镜。评估患者的分期、手术平均失血量、肿瘤残留及（或）复发性肿瘤情况。
A组（19例）平均失血量为1000 ml。19例患者在8 - 24个月的随访中无肿瘤残留或复发。B组（2例）平均失血量为1500 ml。其中1例患者在海绵窦周围有少量残留肿瘤，但在2年的随访中无进展。另1例患者在8个月的随访中无肿瘤残留或复发。
数据表明，经鼻内镜手术技术可用于治疗局限于鼻腔和鼻咽腔的JNA，以及侵犯蝶窦和筛窦甚至轻度颅内侵犯的肿瘤。
