Endonasal Endoscopic Removal of Nasopharyngeal Angiofibroma: Comparison with Conventional Surgery

Lee, Bong Jae; Lee, Seok Ki; Chung, Yoo Sam; Park, Soo Kyoung; Jang, Yong Ju

Abstract

BACKGROUND AND OBJECTIVES
With the improvement in endoscopic sinus surgery skills, most benign tumors of the sino-nasal tract as well as chronic sinusitis are managed with the endonasal endoscopic technique. We have applied endoscopic surgery for juvenile nasopharyngeal angiofibroma (JNA) since 1996. Endonasal endoscopic removal was compared with conventional surgery in the aspect of morbidity, operating time, admission period, and postoperative complications. MATERIALS AND METHOD: Nineteen cases of JNA had been operated by the first author at the Asan Medical Center between 1991 and 2004. Retrospective study was performed with medical records and imaging studies for tumor staging, surgical methods, operation time, and surgical results. Of 19 cases, endonasal endoscopic removal (EER) was applied in 12 cases. EER was compared with conventional surgery (medial maxillectomy). RESULTS: Operation time (55+/-13.1 minutes) and hospitalization periods (5+/-1.3 days) in the cases of EER were shorter than those of conventional surgery (165+/-48.2 minutes, 10+/-0.9 days, respectively, p<0.05). Bleeding amount estimated with differences between preoperative and postoperative hemoglobin levels was smaller in EER (-0.9+/-1.2 g/dL) than in conventional surgery (-2.4+/-1.4 g/dL, p<0.05). CONCLUSION: Fleshy consistency, encapsulation, and benign nature of JNA enable en bloc removal through endonasal endoscopic approach. EER has many advantages over conventional surgery regarding operation time, recovery time, and bleeding amount as well as cosmetic and functional merits.