Alves F RA, Granato L, Maia M S. Acessos Cirúrgicos no Angiofibroma Nasofaríngeo Juvenil – Relato de caso e revisão de literatura. Arch Otolaryngol Head. Juvenile angiofibroma (JNA) is a benign tumor that tends to bleed and occurs in the nasopharynx of prepubertal and adolescent males. Transcript of ANGIOFIBROMA JUVENIL NASOFARINGEO. Estadio I – tumor confinado a la nasofaríngeo. Estadio II – tumor extendido a la.
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To minimize complications, surgery should be performed at centers with extensive experience. Intraoperative control of bleeding during the resection of nasopharyngeal angiofibromas juveil be achieved successfully by temporary clamping of the external carotid arteries in the neck Read it at Google Books – Find it at Amazon.
The first description of an endoscopic resection was published in Antral sign or Holman-Miller sign forward bowing of posterior wall of maxilla is pathognomic of angiofibroma.
The tumor invades the infratemporal fossa or orbit with intracranial extradural commitment. The tumors are frequently located in the posterolateral wall of the nasal cavity, where the sphenoid process of the palatine bone articulates with the base of the pterygoid angiofbiroma, forming the sphenopalatine foramen.
The volume of intraoperative bleeding has been shown to be similar in patients with and without embolization 34whereas tendency to relapse was greater in patients undergoing embolization. Retrieved 29 June Case 3 Case 3. Case 5 Case 5.
Edit article Share article View revision history. All patients were male, and all had symptoms of progressive nasal obstruction and recurrent epistaxis. The combination of different accesses to the tumor can be required 9. We analyzed findings angiofibrroma 20 patients who underwent surgery between and Services on Demand Journal.
The tumor is primarily excised by external or endoscopic approach. Cases and figures Imaging differential diagnosis. From a triangular region formed by the foramen ovale, a round and lacerated tumor may reach the middle fossa, migrating to the parasellar region and remaining generally extradual and lateral to the cavernous sinus.
Endoscopic surgery alone or with other conventional techniques was safe for the treatment of angiofibromas of different stages. Tumors that further extend into the infratemporal fossa may progress into the orbit, through the inferior orbital fissure and to the base of the skull through the base of the pterygoid process. Click here for information on linking to our website or using our content or images.
Case 1 Case 1. All patients were classified radiologically and surgically according to the Fisch system. Nasopharyngeal angiofibroma[TI] free full text[sb]. Sociedade Brasileira de Otorrinolaringologia.
Nasopharyngeal angiofibroma: our experience and literature review
These tests have led to the formulations of multiple classification methods, including the FischRadkowskiAndrewsBremerand Antonelli methods 1,4,5,7,8. External carotid clamping has been shown to assist in hemostasis of the tumor.
Several classification methods have been utilized to stage nasoffaringeo and assist in choosing the appropriate treatment.
Patients undergoing embolization require external carotid clamping due to collateral circulation, which can increase bleeding. Definitive Radiotherapy for Juvenile Nasopharyngeal Angiofibroma.
Introduction Nasopharyngeal angiofibroma is a histologically and biologically benign tumor with aggressive behavior due to its location and associated symptoms including significant epistaxis and nasal obstruction 1 2 3 4 5.
Typically a lobulated non-encapsulated soft tissue mass angiodibroma demonstrated centred on the sphenopalatine foramen which is often widened and usually bowing the posterior wall of the maxillary antrum anteriorly. Intracranial extension can however occur.
The remaining 17 patients, regardless of the tumor classification, underwent naaofaringeo and clamping of the juvenul carotid arteries due to better control of bleeding during surgery. Professor in the Department of Otolaryngology. Case 7 Case 7. The tumor invades the infratemporal fossa or orbit without intracranial involvement.
Intraoperative control of bleeding during the resection of nasopharyngeal angiofibromas can be achieved successfully by temporary clamping of the external carotid arteries in the neck Findings are similar to those described above. These classifications are very important in helping surgeons decide the appropriate surgical approach.
Endoscopic surgery is less invasive than open surgery, causing less damage to the patient. Tumors may invade the anterior fossa through nasofaringso ethmoid and sphenoid sinuses, being more frequent in the middle fossa and remaining extradural 8,9, Endoscopic Surgery for Juvenile Angiofibroma: Although nasal endoscopic surgery is safe, rapid, and effective, studies are needed to assess the importance of preoperative embolization and clamping of the external carotid artery in reducing intraoperative bleeding.
Case 2 Case 2.
A comparative study of surgical approches. Arterial embolization in the management of posterior epistaxis. Arch Otolaryngol Head Neck Surg. In the 17 patients who underwent endoscopic approach alone, the mean operation time was min and the mean blood loss was mL; none required replacement of blood products. Log in Sign up.