Pamuk A E, Özer S, Süslü A E, Akgöz A, Önerci M
Department of Otorhinolaryngology,Akyurt State Hospital,Ankara,Turkey.
Department of Otorhinolaryngology,Faculty of Medicine,Hacettepe University,Ankara,Turkey.
J Laryngol Otol. 2018 Nov;132(11):978-983. doi: 10.1017/S0022215118001779. Epub 2018 Oct 22.
This study aimed to present the clinical features and surgical outcomes of juvenile nasopharyngeal angiofibroma patients who were surgically treated.
The medical records of 48 male patients histologically confirmed as having juvenile nasopharyngeal angiofibroma, who underwent transnasal endoscopic surgery between 2005 and 2016, were retrospectively reviewed.
The overall recurrence rate was 20.8 per cent; however, the recurrence rate differed significantly between patients diagnosed aged less than 14 years (34.7 per cent) and more than 14 years (8 per cent) (p < 0.05). Advanced-stage tumours (Radkowski stage of IIC or more, and Önerci stage of III or more) were more aggressive than earlier stage tumours (p < 0.05 and p < 0.01, respectively). Pre-operative embolisation significantly prolonged mean hospitalisation duration, but had no effect on intra-operative blood loss in patients with advanced-stage tumours (p < 0.001 and p = 0.09, respectively).
The findings show that transnasal endoscopic surgery could be considered the treatment of choice for juvenile nasopharyngeal angiofibroma. Patients diagnosed when aged less than 14 years and those with advanced-stage tumours are at risk of recurrence, and should be monitored with extreme care.
本研究旨在呈现接受手术治疗的青少年鼻咽血管纤维瘤患者的临床特征及手术结果。
回顾性分析2005年至2016年间48例经组织学确诊为青少年鼻咽血管纤维瘤并接受鼻内镜手术的男性患者的病历。
总体复发率为20.8%;然而,年龄小于14岁的患者(34.7%)与年龄大于14岁的患者(8%)之间的复发率存在显著差异(p<0.05)。晚期肿瘤(Radkowski分期为IIC期或更高,Önerci分期为III期或更高)比早期肿瘤侵袭性更强(分别为p<0.05和p<0.01)。术前栓塞显著延长了平均住院时间,但对晚期肿瘤患者的术中失血量无影响(分别为p<0.001和p = 0.09)。
研究结果表明,鼻内镜手术可被视为青少年鼻咽血管纤维瘤的首选治疗方法。年龄小于14岁被诊断出的患者以及晚期肿瘤患者有复发风险,应予以密切监测。