Comparison of two approaches to the surgical management of juvenile nasopharyngeal angiofibroma stages I and II.

OBJECTIVE

Our study was designed to compare two surgical approaches that are currently employed in the treatment of nasopharyngeal angiofibroma stages I and II.

STUDY DESIGN

Retrospective chart review to compare outcomes in 11 patients who underwent endoscopic resection with outcomes of transpalatal excision in 13 patients with juvenile nasopharyngeal angiofibroma (JNA) at our department between 1992 and 2008.

SETTING

Academic otorhinolaryngologic referral centre.

SUBJECTS AND METHOD

Twenty-four patients were divided into two groups according to the surgical technique used. The transpalatal approach was followed for 13 patients, whereas the transnasal endoscopic approach was adhered to for 11. The outcome variables of intraoperative blood loss, length of hospital stay, complications, and rate of recurrence were analyzed.

RESULTS

Compared to the transpalatal surgery group, the transnasal endoscopic group had less intraoperative blood loss (375 ± 27 mL vs 635 ± 41 mL), the mean duration of surgery was significantly shorter (115.7 ± 7.6 minutes vs 141.5 ± 9.8 minutes), and there was a lower occurrence of complications (1 patient vs 6 patients) and a shorter length of hospital stay (4 ± 1.0 days vs 6 ± 1.5 days), but there was no significant difference in the rate of recurrence.

CONCLUSION

In JNA stages I and II, the transnasal endoscopic approach is clearly a good alternative to the transpalatal approach.