Muhammad Raza, Hussain Altaf, Rehman Fazal, Iqbal Johar, Khan Munib, Ullah Gohar, Khan Zakir
J Ayub Med Coll Abbottabad. 2015 Apr-Jun;27(2):388-90.
Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon tumour constituting less than 1% of all head & neck tumours. This tumour has an aggressive local behaviour if left untreated. Surgery is the mainstay of treatment with no common consensus on a single approach. Tumour stage and surgical approaches are the major determinants of outcome. The objective of this study was to evaluate the influence of surgical approaches on tumour recurrence in patients with nasopharyngeal angiofibroma.
This descriptive study was conducted in the Department of ENT and Head and Neck Surgery, PIMS, Islamabad and Ayub Medical Institution, Abbottabad from Jan 2010 to Jan 2014 consisting of 34 diagnosed cases of nasopharyngeal angiofibroma. All patients were treated surgically while radiotherapy was given in a few. All patients were followed up for one year.
Among 34 patients, 25 were treated by lateral rhinotomy approach with medial maxillectomy, 5 by mid-facial degloving approach and 3 by transpalatine approach. One patient with cavernous sinus involvement was treated by radiotherapy. Patients were followed up for one year both by clinical examination and imaging if needed. Recurrence was found in 15% (5/33) patients and postop radiotherapy was given to them.
Lateral rhinotomy approach with medial maxillectomy is highly effective even in advanced stage JNA for complete removal of the disease. Postoperative radiotherapy is an effective adjuvant.
青少年鼻咽血管纤维瘤（JNA）是一种罕见肿瘤，在所有头颈部肿瘤中占比不到1%。若不治疗，该肿瘤具有侵袭性的局部行为。手术是主要治疗方法，对于单一术式尚无普遍共识。肿瘤分期和手术方式是预后的主要决定因素。本研究的目的是评估手术方式对鼻咽血管纤维瘤患者肿瘤复发的影响。
本描述性研究于2010年1月至2014年1月在伊斯兰堡的巴基斯坦医学科学研究所（PIMS）耳鼻喉科及头颈外科以及阿伯塔巴德的阿尤布医疗机构进行，纳入34例确诊的鼻咽血管纤维瘤病例。所有患者均接受手术治疗，少数患者接受了放疗。所有患者均随访一年。
34例患者中，25例采用经鼻侧切开联合上颌骨内侧切除术治疗，5例采用面中部掀翻术治疗，3例采用经腭入路治疗。1例海绵窦受累患者接受了放疗。通过临床检查和必要时的影像学检查对患者进行了一年的随访。15%（5/33）的患者出现复发，并对其进行了术后放疗。
经鼻侧切开联合上颌骨内侧切除术即使在晚期JNA患者中也能高效地完全切除病灶。术后放疗是一种有效的辅助治疗方法。
