Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T12:34:24.887Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of embolisation on endoscopic resection of angiofibroma

Published online by Cambridge University Press:  13 January 2010

M Mohammadi ,
B Saedi  and
A Basam
M Mohammadi
Affiliation:
ENT Research Center, Tehran University of Medical Sciences, Iran
B Saedi*
Affiliation:
ENT Research Center, Tehran University of Medical Sciences, Iran
A Basam
Affiliation:
ENT Research Center, Tehran University of Medical Sciences, Iran
*
Address for correspondence: Dr B Saedi, 141973141 ENT Research Center, Imam Khomeini Medical Center, Bagherkhan Street, Chamran Highway, Tehran 141973141, Iran. Fax: 982166581628 E-mail: saedi@tums.ac.ir
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the effect of embolisation on endoscopic resection of angiofibroma.

Subjects and method:

A partially blinded trial was undertaken. Twenty-three patients with angiofibroma (nine embolised and 14 not embolised) underwent endoscopic resection between January 2007 and August 2008 in two tertiary referral centres. Demographic data were collected, the pre-operative tumour extent was assessed by computed tomography, and tumours were staged according to their computed tomography appearance (Radkowski scale). In addition, we evaluated the duration of surgery, amount of haemorrhage, blood pressure during surgery, duration of hospitalisation, complications of surgery and embolisation, cost of treatment, and number of post-operative recurrences, as well as the angiographic characteristics in the embolisation group.

Results:

There was no significant difference between the general characteristics of both groups. At the end of the study period, we could find no significant difference between the two groups regarding haemorrhage, number of recurrences or complications. The only significant difference was cost of treatment, which was significantly higher in the embolisation group.

Conclusion:

Endoscopic resection is a feasible and safe method for angiofibroma surgery. The current evidence does not support obligatory embolisation in every case of endoscopic angiofibroma resection.

Keywords

AngiofibromaNasopharynxEmbolisationNasal Cavity Neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 6 , June 2010 , pp. 631 - 635
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Carrau, R, Snyderman, C, Kassam, A, Jungreis, C. Endoscopic and endoscopic-assisted surgery for juvenile angiofibroma. Laryngoscope 2001;111:483–7CrossRefGoogle ScholarPubMed
2 Carrillo, JF, Maldonado, F, Albores, O, Ramirez-Ortega, MC. Juvenile nasopharyngeal angiofibroma: clinical factors associated with recurrence, and proposal of a staging system. J Surg Oncol 2008;98:75–80CrossRefGoogle ScholarPubMed
3 Enepekides, DJ. Recent advances in the treatment of juvenile angiofibroma. Curr Opin Otolaryngol Head Neck Surg 2004;12:495–9CrossRefGoogle ScholarPubMed
4 Midilli, R, Karci, B, Akyildiz, S. Juvenile nasopharyngeal angiofibroma: analysis of 42 cases and important aspects of endoscopic approach. Int J Pediatr Otorhinolaryngol 2009;73:401–8CrossRefGoogle ScholarPubMed
5 Nicolai, PB, Tomenzoli, D. Endoscopic surgery for juvenile angiofibroma: when and how. Laryngoscope 2003;113:775–82CrossRefGoogle Scholar
6 Scholtz, WA, Kammen, K. Juvenile nasopharyngeal angiofibroma: management and therapy. Laryngoscope 2001;111:681–7CrossRefGoogle ScholarPubMed
7 Shepherd, G. Pryor, S. EJMJLK. Endoscopic versus traditional approaches for excision of juvenile nasopharyngeal angiofibroma. Laryngoscope 2005;115:1201–7Google Scholar
8 Santaolalla, F, Araluce, I, Zabala, A, López, A, Garay, M, Sanchez, JM. Efficacy of selective percutaneous embolization for the treatment of intractable posterior epistaxis and juvenile nasopharyngeal angiofibroma (JNA). Acta Otolaryngol 2009;129:1–7CrossRefGoogle ScholarPubMed
9 Howard, DL, Lund, V. Recurrence and its avoidance in juvenile angiofibroma. Laryngoscope 2001;111:1509–11CrossRefGoogle ScholarPubMed
10 Liu, LW, Huang, D, Han, D, Ferguson, E. Analysis of intra-operative bleeding and recurrence of juvenile nasopharyngeal angiofibromas. Clin Otolaryngol Allied Sci 2002;27:536–40CrossRefGoogle ScholarPubMed
11 Gupta, AK, Rajiniganth, MG, Gupta, AK. Endoscopic approach to juvenile nasopharyngeal angiofibroma: our experience at a tertiary care centre. J Laryngol Otol 2008;122:1185–9CrossRefGoogle Scholar
12 Schick, BK. Radiologic findings in angiofibroma. Acta Radiol 2000;41:585–93CrossRefGoogle ScholarPubMed
13 Li, R, Shan, X, Wang, L. Evaluation of the effectiveness of preoperative embolization in surgery for nasopharyngeal angiofibroma. Eur Arch Otorhinolaryngol 1998;255:430–2CrossRefGoogle Scholar
14 Jyotip, D. Juvenile nasopharyngeal angiofibroma: clinical factors associated with recurrence and proposal of a staging system. J Surg Oncol 2008;98:73–7Google Scholar
15 Luotonen, STT. Value of pre-operative embolization in surgery for nasopharyngeal angiofibroma. J Laryngol Otol 1993;10:514–21Google Scholar
16 Fonseca, AS, Vinhaes, E, Boaventura, V, De Andrade, NA, Dias, LA, Medeiros, V. Surgical treatment of non-embolized patients with nasoangiofibroma. Braz J Otorhinolaryngol 2008;74:583–7CrossRefGoogle ScholarPubMed
17 Gupta, AK, Bodhey, NK, Kapilamoorthy, TR. Preoperative embolization of hypervascular head and neck tumours. Australas Radiol 2007;51:446–52CrossRefGoogle ScholarPubMed
18 Andrade, NA, Pinto, JA, De Oliveira, M, Brega, M, Aguiar, J, et al. Exclusively endoscopic surgery for juvenile nasopharyngeal angiofibroma. Otolaryngol Head Neck Surg 2007;137:492–6CrossRefGoogle ScholarPubMed
19 Siniluoto, TM, Luotonen, JP, Tikkakoski, TA, Leinonen, AS, Jokinen, KE. Value of pre-operative embolization in surgery for nasopharyngeal angiofibroma. J Laryngol Otol 1993;107:514–21CrossRefGoogle Scholar
20 Borghei, P, Baradaranfar, MH, Borghei, SH, Sokhandon, F. Transnasal endoscopic resection of juvenile nasopharyngeal angiofibroma without preoperative embolization. Ear Nose Throat J 2006;8:11–12Google Scholar
21 De Vincentitis, M, Gallo, A, Minni, A, Torri, E, Tomassi, R, Della Rocca, C. Preoperative embolization in the treatment protocol for rhinopharyngeal angiofibroma: comparison of the effectiveness of various materials. Acta Otolaryngol 1997;17:225–32Google Scholar
22 Eloy, P, Watelet, JB, Hatert, AS, de Wispelaere, J, Bertrand, B. Endonasal endoscopic resection of juvenile nasopharyngeal angiofibroma. Rhinology 2007;45:24–30Google ScholarPubMed
23 Khlifa, M. Endonasal endoscopic surgery for nasopharyngeal angiofibroma. Otolaryngol Head Neck Surg 2001;124:336–7CrossRefGoogle Scholar
24 Da Costa, D, Gessinger, D, Strachan, G. Surgical experience with juvenile nasopharyngeal angiofibroma. Ann Otolaryngol Chir Cervicofac 1992;109:231–4Google ScholarPubMed
25 McCombe, V, Howard, J. Recurrence in juvenile angiofibroma. Rhinology 1990;28:97–102Google ScholarPubMed
26 Onerci, M, Gumus, K, Cil, B, Eldem, B. A rare complication of embolization in juvenile nasopharyngeal angiofibroma. Int J Pediatr Otorhinolaryngol 2005;69:423–8CrossRefGoogle ScholarPubMed
27 Moulin, G, Chagnaud, C, Gras, R, Gueguen, E, Dessi, P, Gaubert, J-Y et al. Juvenile nasopharyngeal angiofibroma: comparison of blood loss during removal in embolized group versus nonembolized group. Cardiovasc Intervent Radiol 1995;18:158–61CrossRefGoogle ScholarPubMed
28 Hosseini, S, Borghei, P, Borghei, S, Ashtiani, M, Shirkhoda, A. Angiofibroma: an outcome review of conventional surgical approaches. Eur Arch Otorhinolaryngol 2005;262:807–12CrossRefGoogle ScholarPubMed