Juvenile Nasopharyngeal Angiofibroma: Stage and Surgical Approach

OBJECTIVE: To study various surgical approaches and the outcome of surgery in juvenile nasopharyngeal angiofibromas (JNA). DESIGN: A descriptive study SETTING: Department of Otorhinolaryngology - Head and Neck Surgery, Civil Hospital Karachi. METHOD: This study included 40 consecutive cases of nasopharyngeal angiofibroma over a period of 4 years. Patients were regularly followed up for any recurrence up to 3 years. RESULTS: Majority of our patients had stage III (72.5%) disease (Chandlers staging) i.e. extension in pterygopalatine fossa, maxillary antrum, nose and sphenoid sinuses; and infratemporal fossa in 72.5% patients, tumor was removed through lateral rhinotomy approach while Weber Fergusson in 17.5%, mid facial degloving in 7.5% and only in 2.5% patient transpalatal approach was used. Tumour recurrence were seen only in 5% of cases. CONCLUSIONS: Angiofibromas usually present at the late stage. Surgery is the treatment of choice. Most of the tumours are excisable by a lateral rhinotomy approach, with minimal chance of recurrence.