The authors have no funding, financial relationships, or conflicts of interest to disclose.
Head and Neck
Juvenile nasopharyngeal angiofibroma
Vascular determinates for operative complications and tumor recurrence
Article first published online: 1 OCT 2013
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 3, pages 672–677, March 2014
How to Cite
Chan, K. H., Gao, D., Fernandez, P. G., Kingdom, T. T. and Kumpe, D. A. (2014), Juvenile nasopharyngeal angiofibroma. The Laryngoscope, 124: 672–677. doi: 10.1002/lary.24337
- Issue published online: 18 FEB 2014
- Article first published online: 1 OCT 2013
- Accepted manuscript online: 8 AUG 2013 07:35AM EST
- Manuscript Revised: 12 JUL 2013
- Manuscript Accepted: 12 JUL 2013
- Manuscript Received: 15 MAY 2013
- head and neck (malignancy);
- nasopharyngeal angiofibroma
Operative complications and tumor recurrence in juvenile nasopharyngeal angiofibroma (JNA) are measurable and meaningful outcomes. This study aimed to assess the association of these two outcomes to various clinical indices and in particular, vascular determinates.
Retrospective cohort study.
An 18-year retrospective chart review of an academic tertiary center was undertaken. Data from clinical notes, imaging studies, and arteriograms were analyzed.
Thirty-seven male (mean age, 14.4 years) patients were included in the study. Tumor stages included: IA (three), IB (three), IIA (14), IIB (three), IIC (five), IIIA (five), and IIIB (four). Four complications (cerebrospinal fluid leak, cerebral vascular accident, and two transient ocular defects) occurred. Eight recurrences occurred within 24 months following surgery. Complications were associated with estimated intraoperative blood loss (EBL) (P = .045). Tumor recurrence was associated with feeding vessels from the contralateral internal carotid artery (ICA) (P = .017). EBL was significantly associated with surgical technique used. EBL, tumor stage, and tumor vascular supply were significantly associated with each other.
Vascular factors were associated with JNA complication and tumor recurrence. EBL might affect complications, and contralateral ICA as a feeding vessel might affect recurrence. EBL was influenced by procedure choice and was interrelated to size and vascular supply of the tumor. This study bolsters the need to decrease intraoperative blood loss by preoperative embolization and use of endoscopic removal techniques. Furthermore, when branches of the ICA are found to be feeding vessels, greater surgical attention for a dry surgical field is encouraged.
Level of Evidence
4 Laryngoscope, 124:672–677, 2014