Surgical management and outcome of juvenile nasopharyngeal angiofibroma in a single centre: A fifteen year experience

Abstract

IntroductionJuvenile nasopharyngeal angiofibroma (JNA) is a locally aggressive benign vascular tumour exclusively amongst adolescence males. General characteristics, management and outcomes of 11 cases of JNA presented to our centre between 2000 till 2015 were studied and evaluated. ObjectiveThis is a retrospective study to determine general characteristics, management and outcomes amongst the local population of Kelantan, Malaysia. Methods11 patients from the local population of Kelantan who presented between 2000 till 2015 were evaluated respectively. Demographical data, clinical presentation, duration of symptoms, stage of disease, surgical approach and outcomes of these 11 patients were reviewed and collected from the medical record office at our centre. ResultsAll 11 patients were Malay male with the average age at diagnosis being 15years (range 11–21) years. Among the local population, predominant clinical presentation includes nasal obstruction followed by spontaneous painless epistaxis. All 11 patients were subjected to embolization prior to surgery. Surgery was the first line treatment for all our patients. Our patients were mostly subjected to endoscopic approach (37%) and combined approach (36%). Recurrence were seen in 5 patients (64%). 2 patients underwent radiotherapy one of which was combined with chemotherapy due to intracranial involvement. None of our patients sustained major intra- or post-operative complications. ConclusionsSurgery combined with preoperative embolization is the main modality of treatment at our centre. Based on our observation, patients delay and refusal of surgery, ineffective embolization have led to recurrence. Timely diagnosis and management together with patients co-operation is critical for successful outcome.