SCIENTIFIC-PRACTICAL JOURNAL

| укр | рус |

 

 
Home Editorial ethics For authors Current issue Archive Contacts

No5(5) 2022

Back to the issue


DOI 10.37219/2528-8253-2022-5-63

Zabolotnyi DI, Zabolotna DD, Ismahilov ER, Tsvirinko IR, Kizim YV
History and modern aspects of treatment of juvenile nasopharyngeal angiofibroma 
Zabolotnyi Dmitry I.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Science of Ukraine”; Kyiv, Ukraine. Director
Doctor of Medical Sciences, Professor, Academician of the National Academy of Medical Sciences of Ukraine
E-mail: amtc@kndio.kiev.ua
https://www.scopus.com/authid/detail.uri?authorId=6701512931
ORCID ID: https://orcid.org/0000-0001-9429-4414

Zabolotna Diana D.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Science of Ukraine”; Kyiv, Ukraine.
Head of Department of Rhinology and Allergology with a group of radiology
Doctor of Medical Sciences, Professor
E-mail: dianazab@ukr.net
ORCID ID: https://orcid.org/0000-0001-7807-8148

Ismahilov Eldar R.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Department of Rhinology and Allergology with a group of radiology
Juniorresearcher
E-mail:ismagilovaldar08@gmail.com
ORCID ID: https://orcid.org/0000-0001-7434-3055

Tsvirinko Irina R.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Department of Rhinology and Allergology with a group of radiology
Juniorresearcher
PhD
E-mail: tsira31@gmail.com
ORCID ID: https://orcid.org/0000-0003-2186-1312

Kizim Yaroslav V.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Department of Rhinology and Allergology with a group of radiology
Juniorresearcher
PhD
E-mail:90kizim@gmail.com
https://orcid.org/0000-0001-5062-7707

Abstract

Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumor that is clinically manifested by epistaxis, usually occurs in males aged 9–27 years and accounts for approximately 0.5% of all head and neck tumors.
The article presents historical data on the diagnosis and treatment of JNA. Modern views on the etiology of JNA are also represented.
The development of such areas of medicine as anesthesiology (intubation, adequate analgesia and anesthesia, hemosubstitution, resuscitation), neuroradiology, endovascular surgery contributed to a further push in solving the problem of JNA. Attempts to visualize and treat this tumor have accompanied the evolution of the surgical treatment of juvenile nasopharyngeal angiofibroma.
Today, the problem of JNA surgery is one of the most controversial and relevant in modern otolaryngology and neurosurgery. The key to this problem is the optimal choice of access to JNA.
The article presents the results of treatment of 32 patients with JNA in the State Institution “Kolomiychenko Institute of Otolaryngology of NAMS of Ukraine. All patients underwent surgery by endoscopic endonasal approach. Selective angiography with embolization was performed only in patients with stages II and III according to Fisch classification. Patients with stage I did not receive embolization. The study protocol included CT and MRI examinations with intravenous contrast to determine the diagnosis and determine the stage of the tumor according to Fisch. Tumor recurrence was observed in 2 patients, and these patients had stage II according to Fisch.
Tumor recurrence in all cases was observed in the pterygopalatine fossa area.

Keywords

juvenile nasopharyngeal angiofibroma, nasopharyngeal angiofibroma, surgical treatment of nasopharyngeal angiofibroma.


Reference

  1. Andrews JC, Fisch U, Valavanis A, Aeppli U, Makek MS: The surgical management of extensive nasopharyngeal angiofibromas with the infratemporal fossa approach. Laryngoscope. 1989;99(4): 429-37. doi: 10.1288/00005537-198904000-00013.
  2. Beham A, Beham-Schmid C, Regauer S, Aubцck L, Stammberger H. Nasopharyngeal angiofibroma: true neoplasm or vascular malformation? Adv Anat Pathol. 2000;7:36-46. doi: 10.1097/00125480-200007010-00006.
  3. Danesi G, Panciera DT, Harvey RJ, Agostinis C. Juvenile nasopharyngeal angiofibroma: evaluation and surgical management of advanced disease. Otolaryngol Head Neck Surg. 2008;138:581-6. doi: 0.1016/j.otohns.2008.01.011.
  4. Danesi G, Panizza B, Mazzoni A, Calabrese V. Anterior approaches in juvenile nasopharyngeal angiofibromas with intracranial extension. Otolaryngol Head Neck Surg: 2000;122:277-83. doi: 10.1016/S0194-5998(00)70256-7.
  5. Fisch U. The infratemporal fossa approach for nasopharyngeal tumors. Laryngoscope. 1983;93 (1):36-44. doi:10.1288/00005537-198301000-00007.
  6. Friedberg SA. Vascular fibromas of the nasopharynx. Arch Otolaryngol. 1940;31:313-26.
  7. Girgis IH, Fahmy SA. Nasopharyngeal fibroma: its histo-pathological nature. J Laryngol Otol. 1973; 87:1107-23.
  8. Gołąbek W, Szymańska A, Morshed K. Transnasal microscopic approach for juvenile nasopharyngeal angiofibroma. Otolaryngol Pol. 2018;72(5):31-6. doi: 10.5604/01.3001.0012.2303.
  9. Grьnwald L. Deskriptive und topographische Anatomie der Nase und ihrer Nebenhцhlen. In: Denker A, Kahler O, editors. Handbuch der HalsNasen-Ohrenheilkunde Bd. 1. Mьnchen: J Springer Berlin JF Bergmann; 1925.
  10. Harrison DFN. The natural history, pathogenesis, and treatment of juvenile angiofibroma. Arch Otolaryngol Head Neck Surg. 1987;113:936-42. doi: 10.1001/archotol.1987.01860090034015.
  11. Howard DJ, Lloyd G, Lund V. Recurrence and its avoidance in juvenile angiofibroma. Laryngoscope. 2001;111:1509-11. doi: 10.1097/00005537-200109000-00003.
  12. Overdevest JB, Amans MR, Zaki P, Pletcher SD, El-Sayed IH. Patterns of vascularization and surgical morbidity in juvenile nasopharyngeal angiofibroma: A case series, systematic review, and metaanalysis. Head Neck. 2018;40(2):428-43. doi:10.1002/hed.24987.
  13. Radkowski D, McGill T, Healy GB, Ohlms L, Jones DT. Angiofibroma. Changes in staging and treatment. Arch Otolaryngol Head Neck Surg. 1996;122(2):122-9. doi: 10.1001/archotol.1996.01890140012004.
  14. Ralli M, Fusconi M, Visconti IC, Martellucci S, de Vincentiis M, Greco A. Nasopharyngeal angiofibroma in an elderly female patient: A rare case report. Mol Clin Oncol. 2018;9(6):702-4. doi: 10.3892/mco.2018.1735.
  15. Schick B, Kahle G. Radiological findings in angiofibroma. Acta Radiol. 2000;41:585-93. doi:10.1080/028418500127345956.
  16. Schick B, Plinkert P, Prescher A. Die vaskulдre Komponente: Gedanken zur Entstehung des Angiofibroms. Laryngo-Rhino-Otol. 2002;81:280-4. doi: 10.1055/s-2002-25322.
  17. Svoboda DJ, Kirchner F. Ultrastructure of nasopharyngeal angiofibroma. Cancer. 1966;19:1949-62. doi: 10.1002/1097-0142(196612)19:12<1949::aid-cncr2820191223>3.0.co;2-3.
  18. Swoboda H, Samec P, Neuwirth-Riedl K. [Therapy of juvenile angiofibroma]. HNO. 1990;38:370-4. [Article in German].
  19. Uslu C, Yildirim M, Uslu H, Sutbeyaz Y, Varoglu E, Seven B, et al. 99mTc-labelled red blood cell single-photon emission computed tomography for the diagnosis and follow-up of juvenile nasopharyngeal angiofibroma. Nucl Med Commun. 2006;
    27:489-94. doi: 10.1097/00003072-200208000-00006.
  20. Wareing MJ, Padgham ND. Osteologic classification of the sphenopalatine foramen. Laryngoscope. 1998;108:125-7. doi:10.1097/00005537-199801000-00024.
  21. Wu AW, Mowry SE, Vinuela F, Abemayor E, Wang MB. Bilateral vascular supply in juvenile nasopharyngeal angiofibromas. Laryngoscope. 2011;121:639-43. doi: 10.1002/lary.21337.
 

© 2019, Public Organization «Ukrainian Scientific Medical Society of Otorhinolaryngologists»