Zeba Ahmed, Atif Hafeez Siddiqui, Iqbal A Muhammad Khyani, Danish-ur Rahim, Muhammad Umar Farooq.
Endoscopic Assisted Management of Juvenile Nasopharyngeal Angiofibroma : Experience at a Tertiary Care Centre.
Pak J Otolaryngol Jan ;30(3):80-3.

OBJECTIVE: To evaluate the efficacy of changing surgical trend in the management of juvenile nasopharyngeal angiofibromas (JNA) with endoscopic assisted surgery at Civil hospital Karachi. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Otorhinolaryngology-Head and Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital Karachi from, January 2002 to March 2014. PATIENTS AND METHODS: This study included 121 consecutive cases of nasopharyngeal angiofibroma over a period of 13 years. Follow up period ranges from 1month to 2years. RESULTS: All patients were male with mean age of 15.4 years. Epistaxis and nasal obstruction were the two most common presenting symptoms. Majority of the patients had stage III disease i-e 78 (64.4%), stage II disease in 23(19%) cases, stage IVa disease was presents in 16(13.2%) cases while stage I seen in 4(3.3%) patients, according to Fisch classification.Surgery was done in all patients. Endoscopic resection was adopted in 74(61.8%) patients while lateral rhinotomy was utilized in 33(27.2%) patients besides other approaches.Tumor recurrence was seen in 8% of cases. CONCLUSION: Angiofibroma usually presents in adolescent males. The triads of nasal obstruction, nasopharyngeal mass and recurrent epistaxis indicate the presence of the neoplasm. The sublabial endoscopic assisted approach is found to have better cosmetically result with removal of disease than other open approaches. Endoscopic techniques allow for excellent visualization and complete tumor resection with low morbidity.

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