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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
(no author information available yet)
No abstract text is available yet for this article.
January 2017: Journal of Neurosurgical Anesthesiology
(no author information available yet)
No abstract text is available yet for this article.
January 2017: Journal of Neurosurgical Anesthesiology
Chikoti Wheat, Ryan J Bickley, Erik Cohen, Danya Wenzler, Nancy Hunter, Donna Astiz
We describe a case of a 24-year-old male presenting urgently with a juvenile nasopharyngeal angiofibroma (JNA) with difficulty breathing, inability to swallow, and respiratory distress following throat swelling. The swelling was reduced with administration of dexamethasone and the JNA was surgically resected within 48 hours. This presentation was atypical given the acuity of presentation and the patient's older age.
2016: Case Reports in Otolaryngology
Jashika Adil Shroff Makhasana, Meena A Kulkarni, Suhas Vaze, Adil Sarosh Shroff
Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumor arising predominantly in the nasopharynx of adolescent males. It is an aggressive neoplasm and shows a propensity for destructive local spread often extending to the base of the skull and into the cranium. Clinically, however, it is obscure with painless, progressive unilateral nasal obstruction being the common presenting symptom with or without epistaxis and rhinorrhea. Diagnosis of JNA is made by complete history, clinical examination, radiography, nasal endoscopy and by using specialized imaging techniques such as arteriography, computer tomography and magnetic resonance imaging...
May 2016: Journal of Oral and Maxillofacial Pathology: JOMFP
Praveen Pandey, Anupam Mishra, Ashoak Mani Tripathi, Veerendra Verma, Ritu Trivedi, Hitendra Prakash Singh, Sunil Kumar, Brijesh Patel, Vinay Singh, Shivani Pandey, Amita Pandey, Subhash Chandra Mishra
OBJECTIVE: An attempt is made to analyze the molecular behavior of juvenile nasopharyngeal angiofibroma (JNA). STUDY DESIGN: Case Series METHODS: Quantification of mRNAs expression was undertaken through real-time polymerase chain reaction in JNA (9-24) samples for VEGF-A, basic fibroblast growth factor (b-FGF), platelet-derived growth factor PDGF-A, KIT proto-oncogene receptor tyrosine kinase (c-Kit), Avian myelomatosis viral oncogene homolog (c-Myc), Harvey rat sarcoma viral oncogene homolog (H-Ras), tumor suppressor gene TP53, and androgen receptor and interleukin 6 (IL-6)...
August 31, 2016: Laryngoscope
Trichy Narayanan Janakiram, Shilpee Bhatia Sharma, Vidya Bhargavan Panicker
To approach Juvenile nasopharyngeal angiofibroma extending to the sphenoid sinus, pterygoid wedge and minimal involvement of the pterygopalatine fossa (Radkowski Stage 2 A) with an endoscopic technique without embolization with no recurrence and minimal morbidity and mortality. This is a retrospective, descriptive study based on the medical records of 15 patients with histologically confirmed JNA who underwent endoscopic binostril four handed endoscopic excision in our centre without embolisation between 2010 and 2015...
September 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
Pradip Kumar Tiwari, Pinpo Teron, Nabajyoti Saikia, H P Saikia, U T Bhuyan, Debajit Das
Juvenile nasopharyngeal angiofibroma is a very rare, highly vascular, uncapsulated and locally invasive tumor. Recently a changing trend has been seen in its epidemiology, pathogenesis, diagnosis, medical management, pre-operative care, surgical management and post-operative care including radiotherapy. Study the changing trend basically in the north-eastern region of south-east Asia and its prospects. Retrospective study of patients presenting with JNA between the study period of 6 months (October 2014-March 2015) in the, Department of Otolaryngology and Head and Neck Surgery, Assam Medical College, Dibrugarh, Assam, India...
June 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
Raghav Mehan, V Rupa, Vijay Kumar Lukka, Munawar Ahmed, Vinu Moses, N K Shyam Kumar
Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular tumour seen in adolescent males. To study the vascular pattern of these tumours, we retrospectively reviewed the records of patients with JNA who underwent preoperative angiography. Most (82.2 %) of the 45 patients assessed were Radkowski stage III with a mean size of 5.29 cm. There was a significant association between tumour stage and size (p = 0.029). Ten different vessels were seen to supply these tumours. All tumours had primary supply from the distal third of the ipsilateral internal maxillary artery (IMA)...
December 2016: European Archives of Oto-rhino-laryngology
Anupam Mishra, Subhash Chandra Mishra
BACKGROUND: An analysis of time distribution of juvenile nasopharyngeal angiofibroma (JNA) from the last 4 decades is presented. METHODS: Sixty recurrences were analyzed as per actuarial survival. SPSS software was used to generate Kaplan-Meier (KM) curves and time distributions were compared by Log-rank, Breslow and Tarone-Ware test. RESULTS: The overall recurrence rate was 17.59%. Majority underwent open transpalatal approach(es) without embolization...
May 2016: American Journal of Otolaryngology
Anupam Mishra, Monica Sachadeva, Ankita Jain, Nimisha Mishra Shukla, Amita Pandey
BACKGROUND: Juvenile nasopharyngeal angiofibroma (JNA) has witnessed a four-fold increase in the incidence at our facility in the current decade as compared to the 1980s. With high global incidence of human pappilloma virus (HPV) related oropharyngeal cancer in India, we hypothesize its implication in JNA as it has not yet been reported. METHODS: Clinico-Surgical variables of 6 patients of JNA were included for correlation and their tissue samples were subjected to western blotting (WB), polymerase chain reaction and immunoflorescence to demonstrate a definite association with HPV...
July 2016: American Journal of Otolaryngology
Hisham Wasl, Jessica McGuire, Darlene Lubbe
BACKGROUND: Surgical approaches for many tumours are often limited by blood loss, exposure and risk to vital anatomical structures. Therefore, the standard of care for certain skull base tumours has become endoscopic transnasal resection. Other surgical disciplines often use cell salvage techniques, but review of the otolaryngology literature revealed very few case reports. This study investigated the value and safety of salvage-type autologous blood transfusion during the endoscopic resection of juvenile nasopharyngeal angiofibromas (JNA)...
April 11, 2016: Journal of Otolaryngology—Head & Neck Surgery
C Langdon, P Herman, B Verillaud, R L Carrau, D Prevedello, P Nicolai, A Schreiber, G Padoan, P Castelnuovo, M Bernal-Sprekelsen
OBJECTIVES: Endoscopic resection has become an established surgical option for most juvenile nasopharyngeal angiofibromas (JNA). However, surgical management of JNA with intracranial extension remains challenging. This retrospective multicenter study reviews a series of patients with advanced stage JNA treated via endonasal/endoscopic approach. METHODS: The experience of five academic tertiary or quaternary care ORL-HNS Departments were included. Medical records of all patients operated for JNA staged as Radkowski stage IIIA or IIIB were reviewed...
September 2016: Rhinology
Anupam Mishra, Subhash Chandra Mishra
This report describes the third case of a true bilateral Juvenile nasopharyngeal angiofibroma (JNA), i.e. two separate JNA arising from both sides simultaneously. The associated multiple recurrences in such a case have not yet been reported. A 21-year-man underwent transpalatal excision and recurred twice. The last 'neo-occurrence' encountered after 2 years was at a different site and was subsequently managed by post-embolization endoscopic resection. A complete report of its clinico-radiological features and management outcome is discussed...
October 2016: European Archives of Oto-rhino-laryngology
Eamon J McLaughlin, Michael J Cunningham, Ken Kazahaya, Julianna Hsing, Kosuke Kawai, Eelam A Adil
OBJECTIVES: To evaluate the feasibility of radiofrequency surgical instrumentation for endoscopic resection of juvenile nasopharyngeal angiofibroma (JNA) and to test the hypothesis that endoscopic radiofrequency ablation-assisted (RFA) resection will have superior intraoperative and/or postoperative outcomes as compared with traditional endoscopic (TE) resection techniques. STUDY DESIGN: Case series with chart review. SETTING: Two tertiary care pediatric hospitals...
June 2016: Otolaryngology—Head and Neck Surgery
Daniel W Scholfield, Marie-Anne Brundler, Ann-Louise McDermott, Francis Mussai, Pamela Kearns
A recent case of advanced, recurrent juvenile nasopharyngeal angiofibroma (JNA) at our institution has highlighted the limited evidence regarding adjunctive treatment. We present the case of a 10-year-old boy who is the first to undergo multiple-staged surgical resections alongside vincristine treatment. We performed a review of the literature analyzing the roles of radiation therapy, cytotoxic drugs, and novel targeted agents in JNA relapse. Small cohort studies suggest radiotherapy and flutamide are the most rational treatment options for residual and recurrent JNA...
April 2016: Journal of Pediatric Hematology/oncology
Lester D R Thompson, Julie C Fanburg-Smith
Several benign and malignant mesenchymal and meningothelial lesions may preferentially affect or extend into the sinonasal tract. Glomangiopericytoma (GPC, formerly sinonasal-type hemangiopericytoma) is a specific tumor with a predilection to the sinonasal tract. Sinonasal tract polyps with stromal atypia (antrochoanal polyp) demonstrate unique histologic findings in the sinonasal tract. Juvenile nasopharyngeal angiofibroma (JNA) arises from specialized tissue in this location. Meningioma may develop as direct extension from its intracranial counterpart or as an ectopic tumor...
March 2016: Head and Neck Pathology
Ozan Gökdoğan, Beyhan Demirhan, Ahmet Koybasioglu, Fikret İleri
Juvenile nasopharyngeal angiofibroma (JNA) is a benign vascular tumor occurring in young males. Treatment of JNA is a complex procedure, especially in advanced cases with a high risk of major complications. We report the clinical, radiological and histological specialties of a rare case of recurrent JNA 3 years after radiation therapy in an 18-year-old boy. The patient underwent endoscopy assisted partial midfacial degloving approach. This treatment has been shown to be effective in advanced JNAs with minor morbidity...
December 2015: Indian Journal of Otolaryngology and Head and Neck Surgery
A I Bello, Jna Quartey, M Lartey
BACKGROUND: The relative efficacy of conventional exercise therapy (CET) and behavioural graded activity (BGA) has not been fully established to inform the preference in clinical practice. OBJECTIVE: To compare CET and BGA on the treatment outcome of chronic non-specific low back pain (LBP). METHODOLOGY: Participants were assigned into either BGA or CET group in this randomized feasibility intervention. The CET group received supervised exercise therapy while BGA group engaged in individually prescribed sub-maximal activities based on time-contingent principles...
September 2015: Ghana Medical Journal
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