Treatment of Nasopharyngeal Angiofibroma: Results According to the Surgical Modalities

An, Yong Hwi; Kim, Si Whan; Jung, Eun Jung; Shim, Woo Sub; Won, Tae Bin; Kim, Yong Min; Lee, Chul Hee; Min, Yang Gi; Rhee, Chae Seo

Abstract

BACKGROUND AND OBJECTIVES
Many surgical techniques are used for the treatment of nasopharyngeal angiofibroma (NAF). This study aimed to analyze the clinical features of NAF and treatment results according to the surgical modalities. MATERIALS AND METHODS: Twenty-five patients with NAF treated at Seoul National University Hospital from January 1990 through December 2004, were analyzed retrospectively by treatment modalities. RESULTS: According to the Sesson staging system, there were 9 patients with type I, 14 with type II, and 2 with type III. Of the 24 patients treated with surgery, there were 7 cases with pure endoscopic surgery and 17 cases with external approaches including 3 transpalatal approach, 5 midfacial degloving approach, 7 transantral approach, and 2 Le Fort I approach. Endoscope-assisted surgery was performed in 6 out of 17 cases who were treated with external approaches. Until 1996, external approaches were conducted in 12 out of 13 cases. Since 1997, pure endoscopic surgery was the most common approach, with 7 out of 12 cases, and it was applied especially in cases below stage IIA. Endoscopeassisted surgery was adjunct to all external techniques since 1997, with 5 out of 5 cases, and it was even applied in advanced cases over stage IIB . All 25 cases were treated successfully without any recurrence or mortality with surgery or radiation therapy. CONCLUSION: Treatment outcomes of pure endoscopic surgery are acceptable compared to those of traditional external approaches with reduced invasiveness and morbidity if proper selection is made depending on the tumor extent. Endoscope-assisted surgery can be helpful in all external approaches to improve visualization, even in advanced lesions.