Juvenile nasopharyngeal angiofibroma: Management and therapy

Objective: To conduct a review of contemporary approaches on the diagnostic -preoperative, operative, and postoperative methods in the management of ju venile nasopharyngeal angiofibroma (JNA), Study Design: Retrospective study of 14 cases of JNA resection at the Department of Otorhinolaryngology, Uni versity of Innsbruck (Innsbruck, Austria) between 1987 and 1998, Methods: D ata was obtained for each patient regarding age, presenting symptoms, durat ion of symptoms, biopsy findings, tumor location, administration of preoper ative angiography and embolization, and surgical approach. The follow-up pe riod ranged from 1 to 13 years, Results: Based on the histological evaluati on by the preoperative biopsy and the tumor location, several surgical appr oaches were applied. A transnasal endoscopic procedure was employed in seve n cases. The preoperative embolization and the intranasal approach with the potassium titanyl phosphate laser minimized blood loss, The recurrence rat e was at a low of 15%, Conclusion: The surgical approach should be determin ed by tumor location, tumor size, and effectiveness of tumor embolization, For patients with JNA with tumor extension involving the nasopharynx, the n asal cavity, the paranasal sinuses, and the pterygopalatine fossa, the tran snasal endoscopic technique offers a minimally invasive resection of the en tire tumor mass with minimal morphological disturbance.