Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh.
Department of Neurosurgery, Neurosurgery Clinic, Birgunj 44300, Nepal.
Medicina (Kaunas). 2023 Sep 7;59(9):1620. doi: 10.3390/medicina59091620.
: Juvenile nasopharyngeal angiofibroma (JNA) is an angiomatous hamartoma of the nasal cavity. It is a benign but locally aggressive vascular tumor of the nasopharynx affecting adolescent males. Many surgical procedures are in practice, but the extended endonasal endoscopic (EEE) approach for JNAs is a suitable and effective technique. : Fifteen adolescent patients having JNA who underwent extended endonasal endoscopic (EEE) surgery from January 2010 to January 2022 were studied retrospectively. Patients having residual and recurrent JNAs and those who underwent surgery other than EEE were excluded. : The average age of the patients was 18.3 years of age. A total of six patients (40%) each had stage V and IV while three patients (20%) had stage III JNAs. Gross total removal was achieved in eight (53.3%) patients and seven (43.7%) had partial removal. There was no per or postoperative mortality. All the patients had at least 3 years of postoperative follow-up and during follow-ups, seven patients were found to have residual tumors, and two had recurrences. : During the last decades, the endoscopic approach for the resection of JNAs has gained increasing popularity due to its obvious advantages over transfacial approaches. The magnified and angled field of view "behind the corner" helping in a more complete inspection for the resection and shorter hospitalization time makes it a better choice than the other approaches. : Endoscopy is an excellent approach for primary JNA. It allows well visualization and precise removal of the angiofibroma. An endoscopic multiangle, multicorridor skull base approach including Denker's anteromedial maxillotomy is suitable and preferable for the resection of extensive JNAs.
青少年鼻咽血管纤维瘤（JNA）是鼻腔的血管错构瘤。它是一种良性但局部侵袭性的鼻咽血管肿瘤，影响青少年男性。目前有许多手术方法，但扩展经鼻内镜（EEE）方法是治疗 JNA 的合适且有效的技术。
回顾性研究了 2010 年 1 月至 2022 年 1 月期间接受扩展经鼻内镜（EEE）手术的 15 例 JNA 青少年患者。排除了有残留和复发性 JNA 以及接受 EEE 以外手术的患者。
患者的平均年龄为 18.3 岁。共有 6 例（40%）患者各有 V 期和 IV 期，3 例（20%）患者有 III 期 JNA。8 例（53.3%）患者实现了完全切除，7 例（43.7%）患者部分切除。无围手术期或术后死亡。所有患者均有至少 3 年的术后随访，随访期间发现 7 例患者有残留肿瘤，2 例有复发。
在过去几十年中，由于经内镜切除 JNA 具有明显优于经面手术的优势，因此这种内镜方法越来越受欢迎。“拐角后”放大和倾斜的视野有助于更全面地检查切除范围，并缩短住院时间，因此它是比其他方法更好的选择。
内镜是原发性 JNA 的极佳治疗方法。它可以很好地可视化并精确切除血管纤维瘤。包括 Denker 前内侧上颌骨切开术在内的内镜多角度、多颅底通道方法适用于广泛 JNA 的切除。
