Unsal Tuna Evrim, Karaca Cihan, Kaymakçi Mustafa, Ozbek Cem, Ozdem Cafer
Department of Otolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2007;17(1):7-12.
Juvenile nasopharyngeal angiofibroma (JNA) cases treated with transpalatal approach were evaluated with respect to localization, complications, intraoperative blood loss, recurrence, and prognosis.
The study included 15 male patients (mean age 13 years; range 10 to 16 years) treated for JNA. The patients were classified according to the Chandler staging system. Transpalatal surgical excision was performed in 14 patients. Preoperative embolization of the maxillary arteries was performed in three patients. One patient with intracranial extension was treated with radiotherapy. The mean follow-up was 3 years and 7 months (range 7 months to 7 years).
Three patients (20%) had Chandler stage II, 11 patients (73%) had stage III, and one patient (7%) had stage IV disease. The mean intraoperative blood loss was 575 ml in three patients with preoperative embolization, and 1,079 ml in those without embolization. The average intraoperative transfusion requirement was 2.3 units. Recurrences developed in three patients (20%), two of whom were treated by surgery and one by radiotherapy.
Transpalatal surgical approach is effective in the treatment of JNAs localized in the nasopharynx, nasal cavity, and sphenoid sinuses, with minimal mortality and morbidity.
对采用经腭入路治疗的青少年鼻咽血管纤维瘤（JNA）病例进行定位、并发症、术中失血、复发及预后方面的评估。
该研究纳入了15例接受JNA治疗的男性患者（平均年龄13岁；范围10至16岁）。患者根据钱德勒分期系统进行分类。14例患者接受了经腭手术切除。3例患者术前行上颌动脉栓塞。1例有颅内扩展的患者接受了放疗。平均随访时间为3年7个月（范围7个月至7年）。
3例患者（20%）为钱德勒II期，11例患者（73%）为III期，1例患者（7%）为IV期疾病。3例术前行栓塞的患者术中平均失血量为575毫升，未行栓塞的患者术中平均失血量为1079毫升。术中平均输血需求量为2.3单位。3例患者（20%）出现复发，其中2例接受了手术治疗，1例接受了放疗。
经腭手术入路对于治疗局限于鼻咽部、鼻腔和蝶窦的JNA有效，死亡率和发病率极低。
