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[Angiofibroma of the base of the skull in children]
Insights
This study details surgical outcomes for skull base angiofibroma in 35 pediatric patients. The nasal-maxillary approach proved effective, though recurrence was noted in some cases, particularly after endonasal removal.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Neurosurgery
Context:
- Skull base angiofibromas are rare, aggressive tumors predominantly affecting young males.
- This study focuses on advanced cases in children, highlighting extensive tumor involvement.
Purpose:
- To evaluate the efficacy and outcomes of surgical management for pediatric skull base angiofibromas.
- To analyze the extent of tumor invasion and recurrence patterns following surgical intervention.
Summary:
- Thirty-five children (3-14 years) with skull base angiofibroma underwent surgery via a nasal-maxillary approach without carotid artery ligation.
- Tumor invasion into the orbit, paranasal sinuses, and cranial fossae was common; 5 patients experienced recurrence, 3 after endonasal removal.
- Radiotherapy showed positive responses in 3 children.
Impact:
- The nasal-maxillary approach offers a viable surgical option for complex pediatric skull base angiofibromas.
- Understanding recurrence patterns informs postoperative management and surveillance strategies.
- This research contributes to optimizing treatment protocols for pediatric skull base tumors.
Abstract:
Throughout 1988-1993 ENT surgeons from the Central Pediatric clinic operated on 35 children aged 3-14 years for angiofibroma of the base of the skull. The majority of the cases were advanced with involvement of all the paranasal sinuses. The tumor has invaded the orbit, pterygopalatine, infratemporal, middle cranial fossa, cavernous sinus and internal carotid artery in 5, 7, 3, 5 and 1 children, respectively. The removal of the tumor was carried out through nasal-maxillary approach without carotid artery ligation. A cosmetic suture was placed subsequently. Anesthetic management has been elaborated. 3 children responded well to radiotherapy. Angiofibroma recurrence occurred in 5 children, in 3 of them after endonasal removal.