Endoscopic Resection of Nasopharyngeal Angiofibroma after Superselective Embolization / 中国微创外科杂志

ABSTRACT

Objective To explore the efficacy of endoscopic surgery for juvenile nasopharyngeal angiofibroma.MethodsDuring 27 years from March 1980 to July 2007,we performed endoscopic surgery on totally 19 patients with nasopharyngeal angiofibromas.According to Radkowski Stating,five of the patients were stage ⅠA,ten were stage ⅠB,and 4 were stage ⅡA.Before the endoscopy,superselective embolization was performed in all the cases via bilateral maxillary arteries.Results All tumors were successfully resected by endoscopy.The intraoperative blood loss was 200-600 ml.One of the stageⅡA patient developed cerebrospinal rhinorrhea during the endoscopic resection,and thus received repair of the middle turbinate by a mucosal patch immediately.In this series of patients,no massive epistaxis,intracerebral infection,or blindness occurred.Follow-up at three months after the surgery by nasoscopy showed epithelialisation of the nasal mucous membrane without residual tumor tissues.Meanwhile,otoscopy revealed normal light reflex of the eardrum,no fluid in the middle ear.Of the patients,eleven were followed up for one to five years,during which none of them had recurrent tumors confirmed by nasoscopy or CT scan.Conclusions Endoscopic resection of nasopharyngeal angiofibroma results in little trauma and few blood loss after superselective embolization.Experience and surgical skills are key points for the operation.