Juvenile nasopharyngeal angiofibromas (JNA) are a rare benign but locally aggressive vascular tumor. Epidemiology Juvenile nasopharyngeal angiofibromas. Introduction: Juvenile nasopharyngeal angiofibroma (NAJ) is a tumor with .. Acessos Cirúrgicos no Angiofibroma Nasofaríngeo Juvenil – Relato de caso e. Juvenile nasopharyngeal angiofibroma (JNA) is a rare and benign but locally aggressive fibrovascular tumor arising from the posterolateral wall of the.
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Detailed information Article for general public English A JNA initially occupies the nasal fossae and cavum and its vascular afferents originate from terminal branches of the internal maxillary artery. Removal is important in preventing nasal obstruction and recurrent epistaxis.
Juvenile nasopharyngeal angiofibroma is a rare, highly vascular, and histologically benign tumor, generally observed in male adolescents. Am J Otolaryngol, 26pp.
Angiofibroma nasofaríngeo juvenil
Other names have been used as a nasopharyngeal fibroma, fibroma of the adolescent and bleeding fibroangioma 1. Surgical treatment of juvenile nasopharyngeal angiofibroma with intracranial extension. Evolution in the Treatment of Juvenile Nasopharyngeal Angiofibroma. Diagnostic and therapeutic management.
These lesions include inflammatory polyps, angiomatous polyps, nasopharyngeal cysts and carcinomas, soft tissue neoplasms such as papilloma, lymphoma, neurofibroma, maxillary malignancies, nasal fossa esthesioneuroblastoma, adenoid hypertrophy, cervical vertebrae cordomas and retropharyngeal ganglia tuberculosis. Preoperative embolisation is recommended in all cases.
Juvemil recurrence rate of endoscopically resected tumors has been shown to be low, and we found that none of our 20 patients experienced tumor recurrence.
Figure 7 shows mast cells in toluidine blue stain. In our case, the average delay between symptom onset and surgery was We can see that this technique allows easier resection of large tumors staged as SCI. Ear Nose Throat J. Embolisation does not juvwnil cause sequelae, although some cases of amaurosis and hemiplegia have been described, 19 as well as paralysis of cranial nerve pairs. Intraoral swelling was diffuse, obliterating the vestibule and extending from the lateral incisor anteriorly till the pharynx posteriorly [ Figure 1 ].
The first description of an endoscopic resection was published in On palpation, the swelling was firm and nontender. This makes it possible to precisely stage JNA. The second patient, also with a Fisch I tumor, underwent clamping of the external carotid arteries without embolization.
Case 4 Case 4. Case 3 Case 3. Maurice M, Milad M.
Pathology Outlines – Nasopharyngeal angiofibroma
Endoscopic resection of JNA, alone or in combination with limited external approaches, is the treatment of choice for JNA in early stages; in certain centres with sufficient experience, JNA in advanced stages are also intervened. Both of them remain free of disease at present. Involvement of cavernous sinus, hypophysis or optic chiasm.
JNA is classified as Type I when the tumor is restricted to the nasal cavity and the nasopharynx without bone destruction, Type II when the tumor invades the pterygomaxillary fossa and maxillary, sphenoidal and ethmoid sinuses with bone destruction, Type III when the tumor invades the infratemporal fossa, the orbit, and the parasellar region but remains lateral to the cavernous sinus and Type IV when the tumor invades the cavernous sinus, the optic chiasma and the pituitary fossa.
This junction forms the upper margin of the sphenopalatine where lies the posterior portion of the middle turbinate. Genetic alterations in juvenile nasopharyngeal angiofibromas.
Some surgeons, however, do not routinely perform embolization preoperatively, finding that embolization is justified only in larger tumors Medical treatment and radiation therapy are only of historical interest.
Juvenile nasopharyngeal angiofibroma
The recurrence rate of tumors resected endoscopically has been shown to be low. To remove the tumor in two patients, the tumor section was performed in two halves, the largest of which was removed by transoral route.
Longer duration of surgery is associated with greater changes in body homeostasis due to surgical trauma. Stage IIIa with extradural intracranial involvement parasellar. Plain radiographs no longer play a role in the workup of a suspected juvenile nasopharyngeal angiofibroma, however they may still be obtained in some instances during the assessment of nasal obstruction, or symptoms of sinus obstructions.
Intracranial extension can however occur. A JNA tumour is histologically benign, but it can be locally aggressive and destructive.
J Oral Maxillofac Pathol. Cases and figures Imaging differential diagnosis. External approaches are divided into anterior, inferior and lateral. In a study published in a number of patients classified juevnil stage IA and IIB Radkowski, were considered by all authors as appropriate for endoscopic resection Steroid hormone receptor expression in nasopharyngeal angiofibromas.
He also complained of difficulty in breathing since 6—7 months. These procedures were performed early in the surgery so we could anchor in parameters and well-known landmarks. The following solution was used topical 1: Subtotal resection of the tumour, along with postoperative radiosurgery and observation, is a valid strategy for patients with intracranial involvement or involvement of vital structures. Classification of Fisch Type I: Juvenile nasopharyngeal angiofibroma JNA is a rare and benign but locally aggressive fibrovascular tumor arising from the posterolateral wall of the nasopharynx, which affects mainly young and adolescent males angiofibrlma usually jucenil between years of age and that presents as a mass in the nasopharynx and nasal cavity, leading to manifestations such as nasal obstruction, epistaxis, profound facial angkofibroma, proptosis or diplopia.
These features along with the specific age and sex predilection can help in differentiating JNA from other nasopharyngeal lesions.
This may be attributed to a rich vasculature and lack of encapsulation. SNES, sinonasal endoscopic surgery. Postoperative coronal C and axial D CT scan of the same patient, after tumour resection through endoscopic sinonasal surgery.
Anterior facial translocation by degloving.