Department of Oral and Maxillofacial Surgery, RV Dental College & Hospital, Bangalore, India.
J Craniomaxillofac Surg. 2012 Feb;40(2):e54-8. doi: 10.1016/j.jcms.2011.03.006. Epub 2011 Mar 31.
The mainstay treatment for Juvenile Nasopharyngeal Angiofibroma (JNA) is complete excision. Surgical approach should allow maximal exposure of the tumour with minimum morbidity. One such possible approach is Lefort I maxillary osteotomy.
To review our experience on feasibility of Lefort I osteotomy approach to achieve the best result and to look at the outcome in our series of patients at a tertiary centre in India.
This prospective study involves 22 patients with JNA who have been treated by Lefort I approach between August 2006 and December 2007 at the Department of Neurosurgery, National Institute of Mental Health And Neurosciences, Bangalore, India.
All patients underwent primary surgical resection through Lefort I approach. No major intra-operative and post-operative complications were noted except in one patient where loss of vision in one eye due to prior pre-operative orbital involvement. The mean follow-up period was 2.8 years. To date, there has been no cases of residual tumour or recurrence that can be attributed to the procedure except in one case.
Our experience suggests that the Lefort I osteotomy approach is a useful technique for the removal of extensive JNA which has distinct advantages over traditional approaches, providing a more direct vision, improved exposure, and cosmesis.
青少年鼻咽血管纤维瘤（JNA）的主要治疗方法是完全切除。手术方法应允许最大限度地暴露肿瘤，同时最大限度地减少发病率。一种可能的方法是 Le Fort I 上颌骨切开术。
回顾我们在印度一家三级中心使用 Le Fort I 截骨术达到最佳效果的经验，并观察我们系列患者的结果。
这项前瞻性研究涉及 22 例 JNA 患者，他们于 2006 年 8 月至 2007 年 12 月期间在印度班加罗尔的国家心理健康和神经科学研究所神经外科接受了 Le Fort I 入路治疗。
所有患者均通过 Le Fort I 入路进行了原发性手术切除。除了 1 例因术前眼眶受累而导致 1 只眼睛失明的患者外，没有观察到主要的术中及术后并发症。平均随访时间为 2.8 年。迄今为止，除了 1 例患者外，没有因该手术而残留肿瘤或复发的病例。
我们的经验表明，Le Fort I 截骨术是一种用于切除广泛 JNA 的有用技术，与传统方法相比具有明显优势，提供更直接的视野、改善的暴露和美容效果。
