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Kareem O Tawfik, Jeffrey J Harmon, Zoe Walters, Ravi Samy, Alessandro de Alarcon, Shawn M Stevens, Todd Abruzzo
OBJECTIVES: To describe a case of the rare complication of facial palsy following preoperative embolization of a juvenile nasopharyngeal angiofibroma (JNA). To illustrate the vascular supply to the facial nerve and as a result, highlight the etiology of the facial nerve palsy. METHODS: The angiography and magnetic resonance (MR) imaging of a case of facial palsy following preoperative embolization of a JNA is reviewed. RESULTS: A 13-year-old male developed left-sided facial palsy following preoperative embolization of a left-sided JNA...
February 1, 2018: Annals of Otology, Rhinology, and Laryngology
Claiton Heitz, Alexandre Weber, Leandro Dini, Guilherme Pivatto Louzada, Eduardo Lombardo
Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumor that occurs predominantly in young males. The authors report the case of a 22-year-old male patient who presented with a painless, exophytic tumor mass protruding through the right nostril, with anterior lateral extension associated with severe posterior involvement, erosion of the sphenoid bone to the right of the pterygoid process, and significant epistaxis. The preoperative evaluation, surgical approach, postoperative results, and a review of the literature are presented...
February 23, 2018: Journal of Craniofacial Surgery
Ritu Gupta, Satya Prakash Agarwal
Juvenile angiofibroma is a rare, highly vascular, histologically benign but locally invasive tumour, affecting predominantly male adolescents. To describe our experience in diagnosis of angiofibroma and treatment by combined endoscopic and transpalatal route. We analysed a case series of 50 patients of nasopharyngeal angiofibroma in Fisch stages I and II who presented at our institute during a period of four years 2011-2014, their clinical presentation, their treatment by combined transpalatal and endoscopic approach, intraoperative and post operative course, complications and tumour recurrence...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
David L McDonagh
No abstract text is available yet for this article.
January 24, 2018: Journal of Neurosurgical Anesthesiology
Xiaole Song, Dehui Wang, Xicai Sun, Jingjing Wang, Zhuofu Liu, Quan Liu, Yurong Gu
BACKGROUND: To determine the learning curve with cumulative sum analysis for endoscopic resection of juvenile nasopharyngeal angiofibroma (JNA) and investigate whether the surgeon's expertise is a risk factor for recurrence. MATERIALS AND METHODS: We reviewed the medical records of patients with JNA who underwent endoscopic or endoscopic-assisted surgery between 2006 and 2015. We used cumulative sum (Cusum) analysis to plot the learning curve for operation time versus chronological sequence, and verified the Cusum curve by risk-adjusted Cusum (RA-Cusum) analysis...
January 24, 2018: Surgical Endoscopy
Jonathan B Overdevest, Matthew R Amans, Peter Zaki, Steven D Pletcher, Ivan H El-Sayed
BACKGROUND: Vascular patterns of juvenile nasopharyngeal angiofibroma (JNA) are poorly defined. We performed both institutional and systematic literature reviews to characterize the relationship between arterial supply patterns of JNA with intraoperative blood loss and tumor recurrence. METHODS: A retrospective review of 26 patients with JNA treated at our institution from 1995 to 2015 with available angiograms, and systematic reviews and meta-analyses of 828 JNA cases undergoing angiographic embolization published between 1995 and 2015 were completed per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
November 11, 2017: Head & Neck
Syed Shahmeer Raza, Syed Muhammad Owais, Salman Zahid, Ihtisham Ul Haq, Haris Manan, Syeda Fizza Qasim, Farhan Ullah, Asfandiar Shahrukh Hijazi, Osamah Riaz Khan
Juvenile Angiofibroma (JNA) is a benign tumour that tends to bleed and occur in the nasopharynx with most cases occurring in pre-pubertal and adolescent males 10-20 years. We present the case of a 50-year-old male shopkeeper who consulted the ENT out patients' department (OPD) of Khyber Teaching Hospital (KTH) with the chief complaint of right sided nasal obstruction for the last 2.5 months which was associated with two episodes of epistaxis and diplopia which started 2 months back. He complained of right sided frontal and periorbital pain for the last 15 days...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
Renuka Bradoo, Anagha Joshi, Kshtij Shah, Tejal Patel, Tanvi Lohiya
The aim of this study is to emphasise the importance of preserving the anterior facial skeleton in angiofibroma surgery and to introduce a new approach by which tumors with far lateral extensions can be operated upon successfully without disruption of the anterior facial skeleton. This is a prospective study conducted at a tertiary referral academic centre. Two patients with extensive juvenile nasopharyngeal angiofibroma with far lateral extensions were recruited and they underwent surgery between July and August 2016...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
Kei Kamiyama, Maiko Satomoto, Kotaro Minami, Yukiko Baba, Koshi Makita
Juvenile nasopharyngeal angiofibroma (JNA) involves difficult anesthetic management because of the risk of massive bleeding, while airway management is rarely a problem in JNA. This report presents an unusual case of JNA causing airway obstruction.
August 2017: Clinical Case Reports
Abanti Das, Ashu S Bhalla, Raju Sharma, Atin Kumar, Alok Thakar, Sreenivas M Vishnubhatla, Mehar C Sharma, Suresh C Sharma
BACKGROUND: To evaluate the role of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) values at 3 Tesla in characterizing sinonasal masses. MATERIAL/METHODS: After ethical clearance, 79 treatment naive patients with head and neck masses underwent magnetic resonance imaging (MRI), including DWI at 3 Tesla using the following b values - 0, 500 and 1000 s/mm(2). Thirty-one patients were found to have sinonasal tumours and were subsequently analysed...
2017: Polish Journal of Radiology
Tran Le, Jacob New, Joel W Jones, Shireen Usman, Sreeya Yalamanchali, Ossama Tawfik, Larry Hoover, Dan E Bruegger, Sufi Mary Thomas
BACKGROUND: Juvenile nasopharyngeal angiofibroma (JNA) is a benign tumor that presents in adolescent males. Although surgical excision is the mainstay of treatment, recurrences complicate treatment. There is a need to develop less invasive approaches for management. JNA tumors are composed of fibroblasts and vascular endothelial cells. We identified fibroblast growth factor receptor (FGFR) and vascular endothelial growth factor (VEGF) expression in JNA-derived fibroblasts. FGFR influences fibroblast proliferation and VEGF is necessary for angiogenesis...
October 2017: International Forum of Allergy & Rhinology
Trichy N Janakiram, Shilpee B Sharma, Ekkehard Kasper, Onkar Deshmukh, Iype Cherian
BACKGROUND: Juvenile nasal angiofibromas (JNA) is a benign lesion with high vascularity and propensity of bone erosion leading to skull base invasion and intracranial extension. It is known to involve multiple compartments, which are often surgically difficult to access. With evolution in surgical expertise and technical innovations, endoscopic and endoscopic-assisted management has become the preferred choice of surgical management. Over the last four decades, various staging systems have been proposed, which are largely based on the extent of nasal angiofibroma...
2017: Surgical Neurology International
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Journal of Neurosurgical Anesthesiology
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Journal of Neurosurgical Anesthesiology
Shilpee Bhatia Sharma, Trichy Narayanan Janakiram, Hina Baxi, Balamurugan Chinnasamy
Juvenile nasopharyngeal angiofibroma is a locally aggressive benign tumour which has propensity to erode the skull base. The tumour spreads along the pathways of least resistance and is in close proximity to the extracranial part of trigeminal nerve. Advancements in expanded approaches for endoscopic excision of tumours in infratemporal fossa and pterygopalatine fossa increase the vulnerability for the trigeminocardiac reflex. The manipulation of nerve and its branches during tumour dissection can lead to sensory stimulation and thus inciting the reflex...
July 2017: European Archives of Oto-rhino-laryngology
Sanjay Roy Chowdhury, K Rajkumar, Tushar Deshmukh
INTRODUCTION: Access osteotomies provide direct exposure to inaccessible areas of the deep part of craniofacial skeleton for treating pathologies involving vital structures. The use of maxillary swing approach for gaining wide access to the nasopharynx, infratemporal fossa, parapharyngeal space, middle fossa of skull base. Though the maxillary swing requires transfacial incision for wide exposure but with careful handling the scar is minimum and this approach can be used in young people...
March 2017: Journal of Maxillofacial and Oral Surgery
Trichy Narayanan Janakiram, Shilpee Bhatia Sharma, Udaya Chanukya Samavedam, Onkar Deshmukh, Bavaharan Rajalingam
Imaging plays an important role in the diagnosis, staging and prognosis of JNA. Certain radiological changes as seen on CECT were observed to be consistent in our case series. This study analysed preoperative and postoperative CECT of large series of JNA patients to evaluate the sites and pattern of spread of tumor. We evaluated the clinical significance of pterygoid wedge in preoperative and postoperative imaging and thus elucidating two new radiological signs. Retrospective analysis of the pre operative and post operative imaging data of 242 patients with JNA...
March 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
Anupam Mishra, Veerendra Verma, Subhash Chandra Mishra
The extranasopharyngeal angiofibroma is a separate clinical entity but those involving infratemporal fossa and cheek resemble juvenile nasopharyngeal angiofibroma (JNA) and hence have been labelled as juvenile perinasal angiofibroma (JPA) in this paper. This paper presents a 7th case of JPA and attempts to review the world literature on JPA, along with a proposal of staging the disease. A 16 year male presented with a painless compressible facial swelling since 7 months without any epistaxis or nasal obstruction...
March 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
Nicholas R Rowan, Nathan T Zwagerman, Molly E Heft-Neal, Paul A Gardner, Carl H Snyderman
Objectives To compare the clinical utility of four juvenile nasal angiofibroma (JNA) staging systems in a large cohort of patients. Design Retrospective case series. Setting Tertiary referral academic center. Participants Pediatric patients undergoing surgical resection of JNAs between January 2008 and June 2015. Main Outcome Measures Intraoperative blood loss and transfusions, number of staged operations, postoperative residual disease, and recurrent disease. Results In total, 34 patients were identified; all underwent preoperative embolization followed by surgery...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
Narayanan Janakiram, Shilpee Bhatia Sharma, Vidya Bhargavan Panicker, C V Srinivas
The role of preoperative embolization in alleviating intra operative haemorrhage in small to medium sized JNA is dubious. We report an unusual case of JNA who developed cerebral edema, hemiplegia and aphasia following glue embolisation and underwent frontotemporal craniectomy. This drastic aftermath of embolisation challenges the safety of preoperative embolisation in such lesions.
December 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
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