Juvenile nasopharyngeal angiofibroma

ABSTRACT

Three hundred and forty five cases of Juvenile Angiofibroma of the Nasopharynx were treated surgically over a period of 30 years, in two teaching hospitals of Pakistan. All patients were male between 9-42 years of age with the highest incidence between 10-25 years [95%] reaching its peak between 16-17 yrs. The youngest patient was a 9 yrs old boy, and the oldest 43. Surgical methods adopted were blind avulsion, Wilson's transpalatine approach, A modification of transpalatine approach, and lateral rhinotomy. The tumours were as small as 3 cm [17 Gram] to as large as 16 cm [42 gm], [mean 10 cm, and 29 Gm.] Minimum follow up period was 18 months, 311 [90.15%] were free of disease, 21 [6.1%]had recurrences, and there were 6 [1.7%] fatalaties. Thirteen cases [3. 7%] of intracranial extention were given post-operative radiotherapy. Average blood loss in this series was 1000-1200 cc. External carotid artery was ligated in 42 [12.17%] cases. Emobilization was not used. Trechecostomy was performed in some of the large tumours. In order to rationalize the management of these unruly tumours, a clinical classification is recommended