Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, P.O. Box 220, 00029, Helsinki, Finland.
Eur Arch Otorhinolaryngol. 2011 Apr;268(4):599-607. doi: 10.1007/s00405-010-1383-z. Epub 2010 Sep 17.
The management of juvenile nasopharyngeal angiofibroma (JNA) has changed during the last decades but it still continues to be a challenge for the multidisciplinary head and neck surgical team. The aim of this study was to review the used treatment approach and outcome of JNA in a single institution series of 27 patients diagnosed and treated during the years 1970-2009. All patients were male, with the median age of 17 years (range 11-33 years). Surgery was used as the primary treatment in every case. Surgical approaches varied, transpalatal approach (N = 14) being the most common approach used in this series. During the last decade various other techniques were applied, including endoscopic (N = 3) resection. Two patients were additionally treated with antiangiogenic agents and one patient with stereotactic radiotherapy. The primary recurrence rate was 37% and it seemed to correlate with vascular density of tumour and the surgical approach used. We suggest that the management of JNA should be planned by an experienced head and neck surgeon, as part of a multidisciplinary team, preferably in a tertiary referral setting, and the recent development of the available therapies should be taken into account to minimise the risk of recurrence.
青少年鼻咽血管纤维瘤（JNA）的治疗在过去几十年中发生了变化，但对于多学科的头颈部外科团队来说，它仍然是一个挑战。本研究旨在回顾单中心 27 例 1970 年至 2009 年诊断和治疗的 JNA 患者的治疗方法和结果。所有患者均为男性，中位年龄为 17 岁（11-33 岁）。手术是所有患者的主要治疗方法。手术方法各不相同，本系列中最常用的方法是经腭入路（N = 14）。在过去十年中，还应用了各种其他技术，包括内镜（N = 3）切除。两名患者还接受了抗血管生成药物治疗，一名患者接受了立体定向放疗。初次复发率为 37%，似乎与肿瘤的血管密度和所使用的手术方法有关。我们建议，JNA 的治疗应由经验丰富的头颈部外科医生作为多学科团队的一部分进行规划，最好在三级转诊中心进行，同时应考虑到现有治疗方法的最新进展，以最大程度降低复发风险。
