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Endoskopik Juvenil Nazofarengeal Anjiofibrom Cerrahisi - Uludağ KBB Sonuçları

Endoscopic Juvenile Nasopharyngeal Angiofibroma Surgery – Uludag ENT Results

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Abstract (2. Language): 
The aim of this study is to evaluate the outcomes of patients with JNA who underwent endoscopic approach surgery. 18 patients who were treated for JNA between 1995 and 2010 at Uludag University (ENT Department ) were retrospectively analyzed. Between April 2007 and March 2010, 6 of these patients who underwent endoscopic resection, were evaluated. Diagnosis of these patients was set by the physical examination and radiological findings. All patients underwent selective angiography-embolization 24 hours prior the surgery. All patients were male and their ages varies between 14 to 21. The majör complaints of the patients were nasal obstruction (6/6, 100%) and epistaxis (5/6, 83%). 5 patients underwent endoscopic approach only to remove the tumor.In only one patient a combination of endoscopic and transmaxillary approach was performed. After primary surgery recurrence was noticed in one patient. No further management was required for that patient because there are no radiologically progressive growth and any symptoms. In the postoperative period, none of the patients had any complications related to surgery or embolism. The endoscopic approach in JNA treatment is a safe method if the preoperative embolization is performed. Since the endoscopic approach significantly reduces the morbidity of patients, this treatment should be prefered as first choice.
Abstract (Original Language): 
Bu çalışmanın amacı Juvenil Nazofarengeal Anjiofibrom (JNA)’un cerrahisinde endoskopik yaklaşımla tedavi edilen olgu serisinin sonuçlarını ortaya koymaktır. Geriye dönük olarak 1995 ile 2010 yılları arasında ve Uludağ Üniversitesi Kulak Burun Boğaz Anabilim Dalı’nda JNA nedeniyle tedavi edilen toplam 18 hasta incelendi. Nisan 2007 – Mart 2010 tarihleri arasında endoskopik olarak rezeksiyon uygulanan 6 hasta değerlendirmeye alındı. Tanı, fizik muayene bulguları ve radyolojik bulgular ile konuldu. Tüm hastalara cerrahiden 24 saat öncesinde selektif anjio-embolizasyon uygulandı. Hastaların yaşları 14 ile 21 arasında değişmekte olup tümü erkekti. Hastalar en sık burun tıkanıklığı (6/6 %100) ve burun kanaması (5/6 %83) semptomlarıyla kliniğimize başvurdu. Beş hastada endoskopik yaklaşımla eksizyon uygulandı. Bir hastada endoskopik ve transmaksiller yaklaşımlar kombine edildi. Bir hastada yineleme görüldü. Radyolojik olarak saptanan yinelemede büyüme ve semptom olmadığı için hasta takip edilmektedir. Postoperatif dönemde hiçbir hastada cerrahiye veya embolizasyona bağlı komplikasyon gelişmedi. JNA tedavisinde endoskopik yaklaşım, preoperatif embolizasyon uygulanması halinde güvenle uygulanabilecek bir yöntemdir. Endoskopik yaklaşım hasta morbiditidesini önemli ölçüde azalttığından öncelikle seçilecek tedavi yöntemi olmalıdır
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REFERENCES

References: 

1. Waldman SR and others. Surgical experience with nasopharyngeal angiofibroma. Arc Otolaryngol Head Neck Surg
1981;107:677.
2. Neel HB and others. Juvenile angiofibroma: review of 120
cases. Am J Surg 1973;126:547.
3. Jafek BW and other.Juvenile nasopharyngeal angiofibroma:
management of intracranial extension. Head Neck Surg
1979;2:119.
4. Gullane PJ and others.Juvenile angiofibroma: a review of the
literature and a case series report. Laryngoscope 1992;102:928.
5. Tyagi I, Syal R, Goyal A. Staging and surgical approaches in
large juvenile angiofibroma-study of 95 cases. Int J Pediatr
Otorhinolaryngol 2006;70:1619-27.
6. Marshall AH, Bradley PJ. Management dilemmas in the treatment and follow-up of advanced juvenile nasopharyngeal angiofibroma. ORLJ Otorhinolaryngol Relat Spec 2006;68:273-8.
7. Korcum AF, Ağırdır BV, Aksu G, Güney K, Dinç O. Nazofarenks anjiofibromlarında tedavi yaklaşımları, Kulak Burun
Boğaz İhtis Derg 2008; 18(4):263-7.
8. Fagan JJ, Snydrman CH, Carrau RL, Janecka IP. Nasopharyngeal angiofibromas: selecting a surgical approach. Head Neck
1997;19:391-9.
9. Radkowski D, McGill T, Healy GB, Ohlms L, Jones DT,
Angiofibroma, Changes in staging and treatment. Arch Otolaryngol Head Neck Surg 1996; 122: 122-9.
10. Lund VJ, Lloyd GAS, Howard DJ. Juvenile angiofibroma:
imaginng techniques in diagnosis. Rhinology 1989; 27:179-85.
11. Burkey B, Kopman CF, Brunberg J. The use of biopsy in the
evaluation of pediatric nasopharyngeal masses. Int J Pediatr
Otorhinolaryngol 1990; 20:169-79.
12. Pryor SG, Moore EJ, Kasperbauer JL. Endoscopic versus
traditional approaches for excision of juvenile nasopharyngeal
angiofibroma. Laryngoscope 2005; 115:1201-7.
13. Mann WJ, Jecker P, Amedee RG. Juvenile angiofibromas:
changing surgical concept over the last 20 years. Laryngoscope
2004;114:291-3.
14. Douglas R, Wormald PJ. Endoscopix surgery for juvenile
nasopharyngeal angiofibroma: where are the limits? Curr Opin
Otolarngol Head Neck Surg 2006;14:1-5.
15. Hoffmann T, Bernal-Sprekelsen M, Koele W, Reittner P, Klein
E, Stammberger H. Endoscopic resection of juvenile angiogibromas-long term results. Rhinology 2005;43:282-9.
16. Önerci TM, Yucel OT, Öğretmenoğlu O. Endoscopic surgery in
treatment of juvenile nasopharyngeal angiofibroma. Int J Pediatr Otorhinolaryngol 2003;67:1219-25.
17. Nicolai P, Berlucchi M, Tomenzoli D, Cappiello J, Trimarchi
M, Maroldi R, et al. Endoscopic surgery for juvenile angiofibroma: when and how. Laryngoscope 2003;113:775-82.
18. Roger G, Tran Ba Huy P, Froehlich P, Van Den Abbeele T,
Klossek JM, Serrano E, et al. Exclusively endoscopic removal
of juvenile nasopharyngela angiofibroma: trends and limits.
Arch Otolaryngol Head Neck Surg 2002;128:928-35.
19. Wormald PJ, Van Hasselt A. Endoscopic removal of juvenile
angiofibromas. Otolarynfol Head Neck Surg 2003;129:684-91.
20. Mair EA, Battiata A, Casler JD. Endoscopic laser-assisted
excision of juvenile nasopharygeal angiofibromas. Arch Otolaryngol Head Neck Surg 2003;129:454-9.
21. Khalifa MA. Endonasal endoscopic surgery for nasopharyngeal
angiofibroma. Otolaryngol Head Neck Surg 2001;124:336-7.
22. Önerci M, Gumus K, Cil B, Eldem B. A rare complication of
embolization in juvenile nasopharyngeal angiofibroma. Int J
Pediatr Otorhinolaryngol 2005;69:423-8.
23. Lloyd G, Howard D, Phelps P, Cheesman A. Juvenile angiofibroma: the lesson of 20 years of modern imaging. J Laryngol
Otol 1999;113:127-34.

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