Juvenile nasopharyngeal angiofibroma in our experience

ABSTRACT

Introduction: Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular histologically benign, locally aggressive neoplasm of the nasopharynx. It accounts for 0.5% of all head and neck neoplasms with a high incidence of persistence and recurrence. Materials and methods: This was a retrospective observational study whereby the medical records of 32 patients treated for Juvenile angiofibroma between May 2010 and August 2016 were reviewed. Results: This study included patients aged between 13-25 years average was 19 years. More than 10 cases were in 14-18years group. This age group exhibits rapidity of growth high incidence of recurrence and early involvement of neibouring structures such as pterygopalatine fossa and infratemporal region and cheek. In 16 cases out of 32 there were attachments of tumor on the roof of nasopharynx. And 8 cases had attachments on the choana. Nasal obstruction and epistaxis is the most common symptom observed in study. CECT was the most common imaging modality utilized for diagnosis and staging of JNA and it was required in all cases. MRI was utilized as an additional investigation in cases with intracranial extention and was required in 37.5% of cases. Postoperative complications were not serious and only included malar defect, ectropion, epiphora and palatal defect. Total complication rate in all was about 28.2%, seen in 11 out of 32 patients. 7 patients were diagnosed with recurrence, with a recurrence rate of about 30%. These recurrences were diagnosed at varying intervals of follow-up 4 out of 13 cases with Stage IIIa and 3 out of 4 cases with Stage IVb diagnosed with recurrence. Conclusion: Radiologic follow-up is essential in the early identification of residual or recurrent disease.