Clinicopathological Study of Juvenile Nasopharyngeal Angiofibroma; a Single Institution Study in a Tertiary Care Hospital In Odisha

ABSTRACT

Background: Aim- To study the presenting features correlates them with radiological finding & the management of JNA. Methods: A prospective study was done on 30 patients who were clinically &radiologically diagnosed as Juvenilenasopharyngeal angiofibroma &treated in department of ENT & HNS SCB Medical College Cuttack during the period of 1.8.2015 to 30.10.2017. All patients are examined & after stabilisation, CECT of nose and PNS done. Staging was done according to clinical &radiological finding by FISCH staging system. Patients were treated by surgical excision by various approaches. Most common procedure done is endoscopic guided excision by medial maxillectomy with lateral rhinotomy approach. Excised tissues send for HP study & patients are followed up for a period of one year. Results: All the patients in our study were males. Majority (70%) are in 11-18 yr age group with mean age of presentation 17.13yr. Most common presenting feature is epistaxis with progressive nasal obstruction. Palatal bulging & hearing loss is the commonest extra sinonasal manifestation. Hollman miller sign found in 50% of cases. Maximum patients presented in stage-2 disease. Post operatively 1 death occurred due to blood transfusion reaction. All patients HP study report is found to be nasopharyngeal angiofibroma. Conclusion: JNA is a benign tumour & should be suspected in all cases of adolescent male presented with epistaxis & progressive nasal obstruction. CECT, has a definite role in diagnosis, staging & plan of management of JNA & should be done within 1 wk prior of surgical management. Ram-Haran sign which is found most of cases of early stage, help in early diagnosis of JNA & can be a diagnostic criteria for JNA. Endoscope assisted external approach, is definitely beneficial in total disease clearance.