Frequency, presentation and management of juvenile nasopharyngeal angiofibroma

ABSTRACT

To determine frequency, clinical presentation and management of juvenile nasopharyngeal angiofibroma [JNA] at Civil Hospital Karachi. A descriptive study. Department of Otorhinolaryngology - Head and Neck Surgery, Dow Medical College, Civil Hospital Karachi and Dow University of Health Sciences from, January 2002 to December 2008. This study included 54 cases of nasopharyngeal angiofibroma over a period of 7 years. Follow up period ranges from 1 month to 7years. All patients were male with an age range of 14 - 17yrs. Epistaxis and nasal obstruction were the two most common presenting symptoms. Majority of our patients 39 [72%] had stage III a disease, stage II disease as seen in 13 [24%] cases while 2 [4%] cases presented in stage I disease according to Fisch classification. Surgery was done in all patients. Tumor recurrence was seen in 4 [7%] of cases. Angiofibroma usually presents in adolescent males. The triads of nasal obstruction, nasopharyngeal mass and recurrent epistaxis indicate the presence of the neoplasm. Surgery is the treatment of choice. Lateral rhinotomy is the most common approach. The sublabial endoscopic assisted approach is cosmetically better than other approaches and has definite advantages. Long term outcome for our patients treated by endoscopic assisted sublabial technique is required to further strengthen our view