ENT Updates

Original Article

Endoscopic Treatment of Juvenile Angiofibromas: Experience of a Tertiary Center from 1993 to 2020

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https://doi.org/10.5152/entupdates.2022.22179
Poels, L., Van Gerven, L., & Jorissen, M. (2022). Endoscopic Treatment of Juvenile Angiofibromas: Experience of a Tertiary Center from 1993 to 2020. ENT Updates, 12(1), 17–28. https://doi.org/10.5152/entupdates.2022.22179
Volume 12 Issue 1 (2022)

Authors

  • Laure Poels Department of Otorhinolaryngology, Head & Neck Surgery, University Hospitals Leuven, Leuven, Belgium
  • Laura Van Gerven Department of Otorhinolaryngology, Head & Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Unit, KU Leuven, Belgium; Department of Neurosciences, Experimental Otorhinolaryngology, Rhinology Research, KU Leuven, Belgium
  • Mark Jorissen
    Department of Otorhinolaryngology, Head & Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Neurosciences, Experimental Otorhinolaryngology, Rhinology Research, KU Leuven, Belgium

Objective: Juvenile angiofibromas are benign tumors that almost exclusively affect male adolescents. Over the last decades, there is an evolution from open surgery toless-invasive endoscopic techniques.

Methods: The medical records of 39 consecutive patients who underwent endoscopic sinus surgery for a juvenile angiofibroma were retrospectively analyzed.

Results: The distribution of the tumor stages according to the classification system ofRadkowski was as follows: 1 in stage IA, 5 in IB, 7 in IIA, 13 in IIB, 5 in IIC, 4 in IIIA, and 4 in IIIB. Preoperative angiography with embolization was performed in all but 1 patient.The mean postoperative follow-up time was 32 months. Five patients (12.8%) hada recurrence after a mean period of 9 months (range 3-24 months), of which 2 ini-tially had incomplete macroscopic tumor removal due to intracranial extension. The mean operating time was 106 minutes (range 35-400 minutes). The mean duration of hospitalization was 4.3 days (range 1-9 days). Two patients (5.1%) had postopera- tive bleeding out of the internal maxillary artery for which a reintervention and blood transfusion was needed.

Conclusions: Endoscopic surgery for juvenile angiofibromas is an effective and safe technique with good outcomes and low postoperative morbidity. This technique should be used as the first choice in the treatment of small to medium-sized tumors(I-IIB) and is a worthy alternative to open surgery for advanced tumor stages (IIC-IIIB) when performed by an experienced surgeon.

Keywords:

Juvenile angiofibroma endoscopic sinus surgery embolization