Presented at the Meeting of the Southern Section of the American Laryngological, Rhinological and Otological Society, Inc., New Orleans, Louisiana, January 15, 1999.
Temporal Approach for Resection of Juvenile Nasopharyngeal Angiofibromas†
Article first published online: 2 JAN 2009
Copyright © 2000 The Triological Society
Volume 110, Issue 8, pages 1287–1293, August 2000
How to Cite
Dale Browne, J. and Jacob, S. L. (2000), Temporal Approach for Resection of Juvenile Nasopharyngeal Angiofibromas. The Laryngoscope, 110: 1287–1293. doi: 10.1097/00005537-200008000-00012
- Issue published online: 2 JAN 2009
- Article first published online: 2 JAN 2009
- Manuscript Accepted: 12 APR 2000
- Juvenile nasopharyngeal angiofibroma;
Objective To describe a lateral preauricular temporal approach for resection of juvenile nasopharyngeal angiofibroma (JNA).
Study Design A retrospective review of five patients with JNA tumors that were resected by a lateral preauricular temporal approach.
Methods The medical records of five patients who underwent resection of JNA tumors via a lateral preauricular temporal approach were reviewed, and the following data collected: tumor extent, blood loss, hospital stay, and surgical complications.
Results Five patients with JNA tumors had resection by a lateral preauricular temporal approach. These tumors ranged from relatively limited disease to more e-tensive intracranial, e-tradural tumors. Using the staging system advocated by Andrews et al., 1 these tumors included stages II, IIIa, and IIIb. Four patients (stages II, IIIa, IIIa, and IIIb) who underwent primary surgical excision had minimal blood losses and were discharged on the first or third postoperative day with minimal transient complications (mild trismus, frontal branch paresis, serous effusion, and cheek hypesthesia). The remaining patient (stage IIIb) did well after surgery, despite having undergone preoperative radiation therapy and sustaining a significant intraoperative blood loss. There have been no permanent complications or tumor recurrences.
Conclusions A lateral preauricular temporal approach to the nasopharynx and infratemporal fossa provides effective exposure for resection of extradural JNA tumors. The advantages of this approach include a straightforward route to the site of origin, the absence of facial and palatal incisions, and avoidance of a permanent ipsilateral conductive hearing loss.