[Transpalatal approach in juvenile nasopharyngeal angiofibroma].

OBJECTIVES

Juvenile nasopharyngeal angiofibroma (JNA) cases treated with transpalatal approach were evaluated with respect to localization, complications, intraoperative blood loss, recurrence, and prognosis.

PATIENTS AND METHODS

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).

RESULTS

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.

CONCLUSION

Transpalatal surgical approach is effective in the treatment of JNAs localized in the nasopharynx, nasal cavity, and sphenoid sinuses, with minimal mortality and morbidity.