Iovanescu Gheorghe, Ruja Steluta, Cotulbea Stan
Department of Otolaryngology, Victor Babes University of Medicine and Pharmacy Timisoara, Romania.
Int J Pediatr Otorhinolaryngol. 2013 Jul;77(7):1186-9. doi: 10.1016/j.ijporl.2013.04.035. Epub 2013 Jun 2.
Juvenile nasopharyngeal angiofibroma is a histologically benign, but very aggressive and destructive tumor found exclusively in young males. The management of juvenile nasopharyngeal angiofibroma has changed in recent years, but it still continues to be a challenge for the multidisciplinary head and neck surgical team.
The purpose of this study was to review a series of 30 patients describing the treatment approach used and studying the outcome of juvenile nasopharyngeal angiofibroma in the ENT Department Timisoara, Romania for a period of 30 years.
The patients were diagnosed and treated during the years 1981-2011. All patients were male. Tumors were classified using Radkowski's staging system. Computed tomography and magnetic resonance imaging allowed for accurate diagnosis and staging of the tumors. Biopsies were not performed. Surgery represented the gold standard for treatment of juvenine nasopharyngeal angiofibroma. All patients had the tumor removed by an external approach, endoscopic surgical approach not being employed in this series of patients.
All patients were treated surgically. Surgical techniques performed were: Denker-Rouge technique in 13 cases (43.33%), paralateronasal technique in 7 cases (23.33%), retropalatine technique in 5 cases (16.66%) and transpalatine technique in 5 cases (16.66%). No preoperative tumor embolization was performed. The recurrence rate was 16.66%. The follow-up period ranged from 1 year to 12 years.
Management of juvenile nasopharyngeal angiofibroma remains a surgical challenge. Clinical evaluation and surgical experience are very important in selecting the proper approach. A multidisciplinary team, with an experienced surgeon and good collaboration with the anesthesiologist are needed for successful surgical treatment.
青少年鼻咽血管纤维瘤是一种组织学上良性但极具侵袭性和破坏性的肿瘤，仅见于年轻男性。近年来，青少年鼻咽血管纤维瘤的治疗方法有所改变，但对于多学科头颈外科团队来说，它仍然是一个挑战。
本研究旨在回顾30例患者，描述所采用的治疗方法，并研究罗马尼亚蒂米什瓦拉耳鼻喉科30年间青少年鼻咽血管纤维瘤的治疗结果。
患者于1981年至2011年期间被诊断和治疗。所有患者均为男性。肿瘤采用Radkowski分期系统进行分类。计算机断层扫描和磁共振成像有助于准确诊断和分期肿瘤。未进行活检。手术是治疗青少年鼻咽血管纤维瘤的金标准。所有患者均通过外部入路切除肿瘤，本系列患者未采用内镜手术入路。
所有患者均接受手术治疗。所采用的手术技术为：Denker-Rouge技术13例（43.33%），鼻旁技术7例（23.33%），腭后技术5例（16.66%），经腭技术5例（16.66%）。未进行术前肿瘤栓塞。复发率为16.66%。随访期为1年至12年。
青少年鼻咽血管纤维瘤的治疗仍然是一项手术挑战。临床评估和手术经验对于选择合适的治疗方法非常重要。成功的手术治疗需要一个多学科团队，包括经验丰富的外科医生以及与麻醉医生的良好协作。
