Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro.
Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
J Craniofac Surg. 2021;32(5):e510-e513. doi: 10.1097/SCS.0000000000007495.
A 13-year-old Japanese boy with a 6-month history of bilateral nasal obstruction and a 3-week history of recurrent epistaxis from the right nose was admitted to our department. Nasal endoscopy revealed a reddish, smooth-walled tumor occupying the right nasal cavity. Computed tomography scan revealed a 3.5 × 4.5 × 7.0-cm heterogeneously enhancing mass involving the right nasal cavity and extending posteriorly to the nasopharynx, and laterally to the pterygopalatine fossa and the medial part of the infratemporal fossa. We diagnosed as juvenile nasopharyngeal angiofibroma with Radkowski classification stage IIC. The internal maxillary and ascending pharyngeal arteries were embolized with polyvinyl alcohol followed by Embosphere using a conventional Seldinger technique. En bloc resection was performed with an endoscopic ipsilateral endonasal and sublabial Caldwell-Luc transmaxillary approach under general anesthesia. As of 3 years postoperatively, no recurrence has been found. We report a child case of juvenile nasopharyngeal angiofibroma successfully treated with less invasive surgery with preoperative embolization.
一位 13 岁的日本男孩，有 6 个月的双侧鼻塞病史和 3 周的右侧鼻出血反复发作史，因上述症状入我院治疗。鼻内镜检查显示右侧鼻腔有一个红色、光滑的肿瘤。计算机断层扫描显示一个 3.5×4.5×7.0 厘米大小的不均匀强化肿块，累及右侧鼻腔，并向后延伸至鼻咽部，向外侧延伸至翼腭窝和颞下窝的内侧部分。我们诊断为青少年鼻咽血管纤维瘤，Radkowski 分期为 IIC 期。采用传统的 Seldinger 技术，用聚乙烯醇对颌内动脉和咽升动脉进行了栓塞，随后用 Embosphere 进行了栓塞。在全身麻醉下，经同侧鼻腔内镜和下唇下 Caldwell-Luc 经上颌窦入路进行整块切除。术后 3 年，未发现复发。我们报告了一例儿童青少年鼻咽血管纤维瘤病例，经术前栓塞的微创手术治疗成功。
