Systematic surgical approach to juvenile angiofibroma

Introduction. Juvenile nasopharyngeal angiofibroma is a rare type of benign vascular tumour that affects only young males, especially those between the ages of 9 and 19. Therapeutic management depends on the extent of the lesion, being conditioned by the complexity of the anatomy of the skull base a...

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Main Authors: Raluca Oana Pulpă, Viorel Zainea, Cătălina Voiosu, Ruxandra Oana Aliuș, Andreea Rusescu, Irina-Gabriela Ioniță, Veronica Epure, Dragoș Octavian Palade, Răzvan Hainăroșie
Format: Article
Language:English
Published: MDPI AG 2024-04-01
Series:Journal of Mind and Medical Sciences
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Online Access:https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1471&context=jmms
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author Raluca Oana Pulpă
Viorel Zainea
Cătălina Voiosu
Ruxandra Oana Aliuș
Andreea Rusescu
Irina-Gabriela Ioniță
Veronica Epure
Dragoș Octavian Palade
Răzvan Hainăroșie
author_facet Raluca Oana Pulpă
Viorel Zainea
Cătălina Voiosu
Ruxandra Oana Aliuș
Andreea Rusescu
Irina-Gabriela Ioniță
Veronica Epure
Dragoș Octavian Palade
Răzvan Hainăroșie
author_sort Raluca Oana Pulpă
collection DOAJ
description Introduction. Juvenile nasopharyngeal angiofibroma is a rare type of benign vascular tumour that affects only young males, especially those between the ages of 9 and 19. Therapeutic management depends on the extent of the lesion, being conditioned by the complexity of the anatomy of the skull base and the risk of massive bleeding due to the abundant vascular supply. The purpose of this article is to describe the modern approach to juvenile nasopharyngeal angiofibroma, starting from the general knowledge on this topic and presenting the experience of our clinic. Materials and Methods. A retrospective study was conducted on 10 male patients with juvenile angiofibroma, with clinical and imaging diagnoses, confirmed by post-ablative histopathological examination. From the 10 juvenile angiofibroma case treated in our clinic, 4 of them were less extensive, 2 with invasion to the pterygopalatine fossa, 3 involving the infratemporal fossa and 1 with minimal intracranial extension. Results. Combined approach (endoscopic trans-nasal approach and Caldwell Luc approach) was necessary in the treatment of a IIC case. Follow-up after surgery was done using MRI scans every 6 months. Recurrence was encountered in one case (9 months from the first surgery), and needed reintervention to remove the residual tumour. Conclusions. Even if it is a rare condition, the development of specific materials and techniques (endoscopic, embolization) has been considerable, allowing the reduction of intraoperative bleeding and residual tumour tissue, in conditions of minimal interference with the facial anatomy of such young patients.
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spelling doaj-art-9a4acde9901a495faca0d0c0f4efefe22025-08-20T03:03:54ZengMDPI AGJournal of Mind and Medical Sciences2392-76742024-04-0111121822410.22543/2392-7674.1471Systematic surgical approach to juvenile angiofibromaRaluca Oana Pulpă0Viorel Zainea1Cătălina Voiosu2Ruxandra Oana Aliuș3Andreea Rusescu4Irina-Gabriela Ioniță5Veronica Epure6Dragoș Octavian Palade7Răzvan Hainăroșie8Carol Davila University of Medicine and Pharmacy, Department of General Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Department of General Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Department of General Surgery, Bucharest, RomaniaProf. Dr. Dan Hociota Institute of Phonoaudiology and Functional ENT Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Department of General Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Department of General Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Department of General Surgery, Bucharest, RomaniaGrigore T. Popa University of Medicine and Pharmacy, Department of Otorhinolaryngology, Iasi, RomaniaCarol Davila University of Medicine and Pharmacy, Department of General Surgery, Bucharest, RomaniaIntroduction. Juvenile nasopharyngeal angiofibroma is a rare type of benign vascular tumour that affects only young males, especially those between the ages of 9 and 19. Therapeutic management depends on the extent of the lesion, being conditioned by the complexity of the anatomy of the skull base and the risk of massive bleeding due to the abundant vascular supply. The purpose of this article is to describe the modern approach to juvenile nasopharyngeal angiofibroma, starting from the general knowledge on this topic and presenting the experience of our clinic. Materials and Methods. A retrospective study was conducted on 10 male patients with juvenile angiofibroma, with clinical and imaging diagnoses, confirmed by post-ablative histopathological examination. From the 10 juvenile angiofibroma case treated in our clinic, 4 of them were less extensive, 2 with invasion to the pterygopalatine fossa, 3 involving the infratemporal fossa and 1 with minimal intracranial extension. Results. Combined approach (endoscopic trans-nasal approach and Caldwell Luc approach) was necessary in the treatment of a IIC case. Follow-up after surgery was done using MRI scans every 6 months. Recurrence was encountered in one case (9 months from the first surgery), and needed reintervention to remove the residual tumour. Conclusions. Even if it is a rare condition, the development of specific materials and techniques (endoscopic, embolization) has been considerable, allowing the reduction of intraoperative bleeding and residual tumour tissue, in conditions of minimal interference with the facial anatomy of such young patients.https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1471&context=jmmsjuvenile angiofibromableedingembolizationsurgery
spellingShingle Raluca Oana Pulpă
Viorel Zainea
Cătălina Voiosu
Ruxandra Oana Aliuș
Andreea Rusescu
Irina-Gabriela Ioniță
Veronica Epure
Dragoș Octavian Palade
Răzvan Hainăroșie
Systematic surgical approach to juvenile angiofibroma
Journal of Mind and Medical Sciences
juvenile angiofibroma
bleeding
embolization
surgery
title Systematic surgical approach to juvenile angiofibroma
title_full Systematic surgical approach to juvenile angiofibroma
title_fullStr Systematic surgical approach to juvenile angiofibroma
title_full_unstemmed Systematic surgical approach to juvenile angiofibroma
title_short Systematic surgical approach to juvenile angiofibroma
title_sort systematic surgical approach to juvenile angiofibroma
topic juvenile angiofibroma
bleeding
embolization
surgery
url https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1471&context=jmms
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AT ruxandraoanaalius systematicsurgicalapproachtojuvenileangiofibroma
AT andreearusescu systematicsurgicalapproachtojuvenileangiofibroma
AT irinagabrielaionita systematicsurgicalapproachtojuvenileangiofibroma
AT veronicaepure systematicsurgicalapproachtojuvenileangiofibroma
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