Borghei Peyman, Baradaranfar Mohammad Hossein, Borghei Seyed Hebatodin, Sokhandon Farnoosh
Ear, Nose, Throat Research Center, Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ear Nose Throat J. 2006 Nov;85(11):740-3, 746.
Juvenile nasopharyngeal angiofibroma (JNA) is a benign, highly vascular, and locally invasive tumor. Because the location of these tumors makes conventional surgery difficult, interest in endoscopic resection is increasing, particularly for the treatment of lesions that do not extend laterally into the infratemporal fossa. We report the results of our series of 23 patients with JNA (stage IIB or lower) who underwent transnasal endoscopic resection under hypotensive general anesthesia without preoperative embolization of the tumor All tumors were successfully excised. The amount of intraoperative blood loss was acceptable. We observed only 1 recurrence, which was diagnosed 19 months postoperatively in a patient with a stage IIB primary tumor. We observed only 3 complications during follow-up-all synechia. We conclude that endoscopic resection of JNAs is safe and effective. The low incidence of recurrence and complications in this series indicates that preoperative embolization may not be necessary for lesions that have not undergone extensive spread; instead, intraoperative bleeding can be adequately controlled with good hypotensive general anesthesia.
青少年鼻咽血管纤维瘤（JNA）是一种良性、高血管性且具有局部侵袭性的肿瘤。由于这些肿瘤的位置使得传统手术困难，因此对内镜切除术的兴趣日益增加，特别是对于未向外侧延伸至颞下窝的病变的治疗。我们报告了我们系列的23例JNA患者（IIB期或更低分期）的结果，这些患者在低血压全身麻醉下接受了经鼻内镜切除术，且术前未对肿瘤进行栓塞。所有肿瘤均成功切除。术中失血量可接受。我们仅观察到1例复发，在一名IIB期原发性肿瘤患者术后19个月被诊断出。在随访期间我们仅观察到3例并发症——均为粘连。我们得出结论，内镜切除JNA是安全有效的。本系列中复发和并发症的低发生率表明，对于未广泛扩散的病变，术前栓塞可能没有必要；相反，术中出血可以通过良好的低血压全身麻醉得到充分控制。
