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Craniofacial approaches to large juvenile angiofibromas
M Yashar S Kalani1, Maziyar A Kalani, Samuel Kalb
1Division of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona 85013, USA.
Craniofacial approaches effectively resect large juvenile nasopharyngeal angiofibromas, achieving high gross-total resection rates with minimal mortality. This method offers an excellent surgical avenue with acceptable morbidity.
Area of Science:
- Neurosurgery
- Otolaryngology
- Head and Neck Surgery
Background:
- Juvenile nasopharyngeal angiofibromas (JNA) are rare, benign tumors.
- Large JNAs pose significant surgical challenges due to their location and vascularity.
Purpose of the Study:
- To review the authors' experience with craniofacial approaches for resecting large JNAs.
- To evaluate the efficacy and safety of craniofacial resection for these tumors.
Main Methods:
- Retrospective review of 30 procedures in 22 male patients (mean age 15 years) between 1992 and 2009.
- All patients underwent preoperative embolization.
Main Results:
- Gross-total resection was achieved in 77% of cases.
- Complications occurred in 41%, most commonly cerebrospinal fluid (CSF) leakage (23%).
- No surgery-related mortality was observed, with 100% of patients showing improved or stable Karnofsky Performance Scale scores.
Conclusions:
- Craniofacial approaches are an excellent surgical option for large JNAs.
- These approaches offer acceptable morbidity rates and a zero mortality rate for JNA resection.
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