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Maria Fernanda Galindo
Mexican Social Security Institute, MéxicoTitle: Risk Factors For Relapse In Juvenile Nasopharygeal Angiofibroma
Abstract
Juvenile
nasopharyngeal angiofibroma (JNA) is a rare benign neoplasm, it presents mainly
in adolescent males as nasal obstruction and ipsilateral epistaxis, its diagnosis
is based on diagnostic suspicion, imaging studies and angiography. Surgical
management preceded by embolization and in some cases, radiotherapy is also
used. The aim of the present study was to perform a detailed analysis to
correlate age at diagnosis, diagnostic stage, time of evolution, relapse, time
of pre-surgical embolization and surgical procedure to determine whether any of
these factors present a risk for relapse.
The average age
at diagnosis was 16 years, 5 patients presented with stage IIIA, 2 in IIA and
IIC and 1 in IA, IIB and IIIB. Angiography showed predominant irrigation of the
internal maxillary artery. Embolization was performed between 24 and 120 hours
before surgery. The surgical approach was performed depending on the diagnostic
stage, open technique was used in 7 patients, endoscopic technique in 3 and
combined in 2. During the follow-up, relapse occurred in 6 patients, 4 were
residual tissue and 2 were de novo growths. The average number of months for
relapse was 11 + 6.7 months. Relapse was managed by isolated surgical revision
in 2 patients, single radiotherapy in 2 others and with both treatments in the
remaining 2.
With that results we conclude that there is a
higher risk of relapse in patients with earlier age of onset, those with
irrigation of the internal carotid system, pre-surgical embolization greater
than 72 hours and those who after the surgical procedure present residual
tissue, even if is minimal. Relapse occurred in a higher percentage within the
first year after resection.
Biography
María Fernanda Galindo has completed medicine by the National Autonomous University of Mexico and her specialty in Otolaryngology, head and neck surgery from Guanajuato University and Mexican social security institute at the age of 29 years. Currently she is attached to the department of ENT of national medical center la Raza.
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