Garofalo Pietro, Pia Francesco, Policarpo Mario, Tunesi Sara, Valletti Paolo Aluffi
*E.N.T. Department †Translational Medicine Department, Unit of Medical Statistics and Cancer Epidemiology, University "Amedeo Avogadro" of Piemonte Orientale, Novara, Italy.
J Craniofac Surg. 2015 May;26(3):918-821. doi: 10.1097/SCS.0000000000001693.
Juvenile nasopharyngeal angiofibroma (JNA) is a rare vascular and fibrous tumor that most commonly affects males in prepuberal and adolescent age. Traditionally, these tumors have been removed, after selective embolization, with the open surgical approach (degloving), but the interest in the endoscopic resection, especially for small tumors, has increased in recent years. To present our experience of JNA management, comparing the endoscopic approach and open/combined approach.
We conducted a retrospective, cross-sectional, and descriptive study of 12 young men, ages between 9 and 19 years (mean: 13), suffering from nasopharyngeal angiofibroma and treated with open surgery (N = 6), with endoscopic excision (N = 5) or with combined approach (N = 1). We reviewed demographical data, clinical presentation, surgical approach as well as time of surgery, of hospitalization, need of blood transfusion during surgery, and complications occurred during hospitalization.
All JNA patients were male. The average age at diagnosis was 13.7 years (range 9-19 years). Approximately, 8.3% were classified as Önerci I, 41.7% as Önerci II, and 50.0% as Önerci III. Preoperative embolization was carried out in all patients. All patients were submitted to primary surgical resection, and 2 of them required intraoperative blood transfusion. The overall recurrence rate was 8.3% and the cure rate was 100%.
This study confirmed that endoscopic approach gives excellent results in small and medium dimensions tumors, whereas open surgery remains a safe procedure for patients with larger tumors.
青少年鼻咽血管纤维瘤（JNA）是一种罕见的血管性和纤维性肿瘤，最常见于青春期前和青春期的男性。传统上，这些肿瘤在选择性栓塞后通过开放手术方法（掀翻术）切除，但近年来，内镜切除术的应用兴趣有所增加，尤其是对于小肿瘤。为了介绍我们在JNA治疗方面的经验，比较内镜手术方法和开放/联合手术方法。
我们对12名年龄在9至19岁（平均13岁）的患有鼻咽血管纤维瘤的年轻男性进行了一项回顾性、横断面和描述性研究，这些患者接受了开放手术（N = 6）、内镜切除术（N = 5）或联合手术方法（N = 1）。我们回顾了人口统计学数据、临床表现、手术方法以及手术时间、住院时间、手术期间输血需求和住院期间发生的并发症。
所有JNA患者均为男性。诊断时的平均年龄为13.7岁（范围9 - 19岁）。大约8.3%被分类为Önerci I级，41.7%为Önerci II级，50.0%为Önerci III级。所有患者均进行了术前栓塞。所有患者均接受了一期手术切除，其中2例需要术中输血。总复发率为8.3%，治愈率为100%。
本研究证实，内镜手术方法在中小尺寸肿瘤中能取得优异效果，而开放手术对于较大肿瘤患者仍然是一种安全的手术方式。
