Juvenile nasopharyngeal angiofibroma. 12 years experience at the University of Chile Clinical Hospital

Abstract

Introduction: Juvenile nasopharyngeal angiofibroma is a vascular tumor that occur almost exclusively in the nasopharynx of adolescent males. Its management is complex because of its vascular nature and frequent recurrence. Aim: To review the experience of 12 years in juvenile nasopharyngeal angiofibroma. Material and method: Retrospective study of patients admitted with diagnosis of juvenile nasopharyngeal angiofibroma at the Otorhinolaryngology Department, University of Chile Clinical Hospital, between 1996 and 2008, characterizing the study group in terms of clinical features, diagnosis, treatment, complications and recurrences. Results: We obtained a total of 22 patients, all male, with an average age of 17.7 years. The most common presenting symptom was recurrent epistaxis, present in up to 81.8% of cases. All patients were studied with computed tomography and received preoperative arterial embolization. Most tumors were type II B and C (68.1%) and the endoscopic surgical technique was predominant. There was only one major complication, but derived from the embolization procedure and not the surgery itself. There was a 22.7% recurrence, with disease-free time of 8.2 months on average. Discussion and conclusion: Our results agree with most of the series published in the literature. The therapeutic decision is based on the determination of tumor size and extension, preferring an initial endoscopic approach, for its minimally invasive nature and because they present less bleeding, surgical time and hospital stay, if the tumor stage allows. Arterial embolization, regardless of the surgical approach, should be routine.