Angiofibromas of the Nasopharynx
Betka J., Lischkeová B., Belšan T.*, Bohutová J.**
Klinika otorinolaryngologie a chirurgie hlavy a krku 1. LF UK a FN Motol, Praha, katedra otorinolaryngologie IPVZ, Praha, přednosta prof. MUDr. J. Betka, DrSc. Klinika zobrazovacích metod 2. LF UK a FN Motol, Praha, přednosta doc. MUDr. J. Neuwirth, CSc.* Radiodiagnostická klinika IPVZ FN Bulovka, Praha, přednosta prof. MUDr. J. Bohutová, DrSc.** |
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Summary:
The objective of the study was to evaluate the classification, therapeutic procedures
and therapeutic results in patients with angiofibroma of the nasopharynx. The study was retrospective, all results of preoperative imaging methods (CT and/or MR) were for the purpose of classification re-evaluated by one doctor. In the trial patients were included where the minimal follow up
period was 12 months. The group comprised 22 patients operated in 1989-1999. Three patients of
this group were operated on account of a relapse. The group comprised men aged 14-36 years, the
mean being 22 years. Radiological staging according to Chandler was used. The therapeutic results
were evaluated on the basis of diagnostic imaging during the postoperative period. In all patients
CT was used and/or MR within the 7th postoperative day to rule out or confirm a residual tumour.
A relapse of a tumour was diagnosed in patients without a postoperative residue where during the
subsequent follow up a relapse of a tumour was proved by an imaging method.
The group did not comprise any patients with radiological classification I, five patients were
classified as stage II, fourteen had classification III and three patients classification IV. In 18
patients preoperative embolization of the afferent vessels was made. In all patients on surgery the
approach was via medial maxillectomy by incision from lateral rhinotomy, in one patient this
approach was combined with the orbitozygomatic approach. In 18 patients (82 %) the operation was
radical, i.e. without a detectable residue after surgery. Patients with a residue were carefully
radiologically monitored, in one patient progression of the disease occurred and he was indicated
for irradiation with Leksell’s gammaknife. In three patients a relapse of the disease developed. The
relapses were treated by surgery, in one patient in combination with irradiation with Leksell’s
gammaknife. The residues and relapses were found in patients with tumours in the more advanced
stages, i.e. III and IV.
Key words:
angiofibroma, embolization, surgery, classification.
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