Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-27T09:14:30.844Z Has data issue: false hasContentIssue false
  • English
  • Français

Value of pre-operative embolization in surgery for nasopharyngeal angiofibroma

Published online by Cambridge University Press:  29 June 2007

Topi M. J. Siniluoto ,
Jukka P. Luotonen ,
Tapani A. Tikkakoski ,
Aaro S. S. Leinonen  and
Kalevi E. Jokinen
Topi M. J. Siniluoto*
Affiliation:
Departments of Diagnostic Radiology, University Central Hospital of Oulu, University of Oulu, Kajaanintie 50, SF-90220 Oulu, Finland
Jukka P. Luotonen
Affiliation:
Departments of Otorhinolaryngology, University Central Hospital of Oulu, University of Oulu, Kajaanintie 50, SF-90220 Oulu, Finland
Tapani A. Tikkakoski
Affiliation:
Departments of Diagnostic Radiology, University Central Hospital of Oulu, University of Oulu, Kajaanintie 50, SF-90220 Oulu, Finland
Aaro S. S. Leinonen
Affiliation:
Departments of Diagnostic Radiology, University Central Hospital of Oulu, University of Oulu, Kajaanintie 50, SF-90220 Oulu, Finland
Kalevi E. Jokinen
Affiliation:
Departments of Otorhinolaryngology, University Central Hospital of Oulu, University of Oulu, Kajaanintie 50, SF-90220 Oulu, Finland
*
Topi Siniluoto, M.D., Department of Diagnostic Radiology, University of Oulu, Kajaanintie 50, SF-90220 Oulu, Finland
Get access Rights & Permissions [Opens in a new window]

Abstract

The value of embolization in surgery for nasopharyngeal angiofibroma is a controversial matter. We analysed retrospectively the results of surgical treatment in ten patients with a nasopharyngeal angiofibroma, the last five of whom underwent pre-operative embolization with Gelfoam®. Embolization reduced the intraoperative blood loss at primary surgery from an average of 1510 ml in the non-embolized patients to 510 ml in the embolized patients and transfusions from an average of 4.4 units to none. Seven reoperations were performed on four non-embolized patients on account of tumour recurrence, while no recurrences were diagnosed among the pre-operatively embolized patients. Blood loss in the reoperations averaged 4065 ml, and transfusions 7.1 units. The results indicate that embolization is effective in reducing intraoperative blood loss and contributes to improved surgical results. We recommend it as a routine pre-operative adjunct to surgery for nasopharyngeal angiofibroma.

Keywords

Nasopharyngeal neopiasmsangiofibromaAngiographyEmbolizationtherapeuticSurgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 6 , June 1993 , pp. 514 - 521
Copyright
Copyright © JLO (1984) Limited 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amedee, R., Klaeyle, D., Mann, W., Geyer, H. (1989) Juvenile angiofibromas: a 40-year surgical experience. Journal of Oto-Rhino-Laryngology and its related Specialities 51: 56–61CrossRefGoogle ScholarPubMed
Batsakis, J. G. (1979) Vasoformative tumors: angiofibroma. In Tumors of the head and neck: Clinical and pathological considerations. 2nd Edition. Williams & Wilkins Co., Baltimore, pp. 296–300.Google Scholar
Bremer, J. W., Ned, H. B., DeSanto, L. W., Jones, G. C. (1986) Angiofibroma: treatment trends in 150 patients during 40 years. Laryngoscope 96: 1321–1329CrossRefGoogle Scholar
Bryan, R. N., Sessions, R. B., Horowitz, B. L. (1981) Radiographic management of juvenile angiofibromas. American Journal of Neuroradiology 2: 157–166Google ScholarPubMed
Chandler, J. R., Goulding, R., Moskowitz, L., Quencer, R. M. (1984) Nasopharyngeal angiofibromas: staging and management. Annals of Otology, Rhinology and Laryngology 93: 322–329CrossRefGoogle Scholar
Davis, K. R. (1987) Embolization of epistaxis and juvenile nasopharyngeal angiofibromas. American Journal of Roentgenology 148: 209–218CrossRefGoogle ScholarPubMed
Duvall, A. J., Moreano, A. E. (1987) Juvenile nasopharyngeal angiofibroma: diagnosis and treatment. Otolaryngology—Head and Neck Surgery 97: 534–540CrossRefGoogle ScholarPubMed
Economou, T. S., Abemayor, E., Ward, P. (1988) Juvenile nasopharyngeal angiofibroma: an update of the UCLA experience, 1960–1985. Laryngoscope 98: 170–175CrossRefGoogle ScholarPubMed
Edner, G., Anniko, M., Hindmarsch, T., Lindquist, P.-G., Wersäll, J. (1982) Balloon emobolization of the sphenoid artery in a case of a juvenile angiofibroma. Archives of Otolaryngology 234: 225–233Google Scholar
Gay, I., Elidan, J., Gordon, R. (1983) Oronasal fistula—a possible complication of preoperative embolization in the management of junvenile nasopharyngeal angiofibroma. Journal of Laryngology and Otology 97: 651–656CrossRefGoogle Scholar
Jacobsson, M., Petruson, B., Svendsen, P., Berthelsen, B. (1988) Juvenile nasopharyngeal angiofibroma. A report of eighteen cases. Acta Oto-Laryngologica 105: 132–139CrossRefGoogle ScholarPubMed
Jafek, B. W., Krekorian, E. A., Kirsch, W. N., Wood, R. P. (1979) Juvenile nasopharyngeal angiofibroma: management of intracranial extension. Head and Neck Surgery 2: 119–128CrossRefGoogle ScholarPubMed
Katsiotis, P., Tzortzis, G., Karaminis, Ch. (1979) Transcatheter arterial embolization in nasopharyngeal angiofibroma. Acta Radiologica: Diagnosis 20: 433–438CrossRefGoogle ScholarPubMed
Lasjaunias, P., Picard, L., Manelfe, C., Moret, J., Doyon, D. (1980) Angiofibroma of the nasopharynx. Journal of Neuroradiology 7: 73–95Google ScholarPubMed
Lund, V. J., Lloyd, G. A. S., Howard, D. J. (1989) Juvenile angiofibroma: imaging techniques in diagnosis. Rhinology 27: 179–185Google ScholarPubMed
McCombe, A., Lund, V. J., Howard, D. J. (1990) Recurrence in juvenile angiofibroma. Rhinology 28: 97–102Google ScholarPubMed
Natvig, K., Skalpe, I. O. (1984) Pre-operative embolization of juvenile nasopharyngeal angiofibromas with gelfoam. Journal of Laryngology and Otology 98: 829–833CrossRefGoogle ScholarPubMed
Piquet, J. J., Chevalier, D. (1989) Surgical experience of angiofibromas of the nasopharynx—34 cases. Rhinology 27: 149–154Google Scholar
Pletcher, J. D., Newton, T. H., Deflo, H. H., Nomian, D. (1975) Preoperative embolization of juvenile angiofibromas of the nasopharynx. Annals of Otology, Rhinology and Laryngology 84: 740–746CrossRefGoogle ScholarPubMed
Roberson, G. H., Biller, H., Sessions, D. G., Ogura, G. H. (1972) Presurgical internal maxillary artery embolization in juvenile angiofibroma. Laryngoscope 82: 1524–1532CrossRefGoogle ScholarPubMed
Roberson, G. H., Price, A. C., Davis, J. M., Gulati, A. (1979) Therapeutic embolization of juvenile angiofibroma. American Journal of Roentgenology 133: 657–663CrossRefGoogle ScholarPubMed
Rosen, L., Hanafee, W., Nahum, A. (1966) Nasopharyngeal angiofibroma, an angiographic evaluation. Radiology 86: 103–107CrossRefGoogle ScholarPubMed
Russell, E. J. (1986) Functional angiography of the head and neck. American Journal of Neuroradiology 7: 927–936Google ScholarPubMed
Sherry, R. G., Anderson, R. E., Kruger, R. A., Nelson, J. A. (1983) Real-time digital subtraction angiography for therapeutic neuroradiological procedures. American Journal of Neuroradiology 4: 1171–1173Google Scholar
Soong, H. K., Newman, S. A., Kumar, A. A. J. (1982) Branch artery occlusion. An unusual complication of external carotid embolization. Archives of Ophthalmology 100: 1909–1911CrossRefGoogle ScholarPubMed
Steinberger, S. J., Wetmore, R. F. (1984) Current management of juvenile nasopharyngeal angiofibroma. Transactions—Pennsylvania Academy of Ophthalmology and Otolaryngology 37: 65–70Google ScholarPubMed
Waldman, S. R., Levine, H. L., Astor, F., Wood, B. G., Weinstein, M., Tucker, H. M. (1981) Surgical experience with nasopharyngeal angiofibroma. Archives of Otolaryngology 107: 677–682CrossRefGoogle ScholarPubMed
Ward, P. H. (1983) The evolving management of juvenile nasopharyngeal angiofibroma. Journal of Laryngology and Otology. Supplement 8: 103–104Google Scholar
Ward, P. H., Thompson, R., Calcaterra, T., Kadin, M. R. (1974) Juvenile angiofibroma. A more rational therapeutic approach. Based upon clinical and experimental evidence. Laryngoscope 84: 2181–2194CrossRefGoogle ScholarPubMed
Weinstein, M. A., Levine, H., Duchesneau, P. M., Tucker, H. M. (1978) Diagnosis of juvenile angiofibroma by computed tomography. Radiology 126: 703–705CrossRefGoogle ScholarPubMed
Wilson, G. H., Hanafee, W. N. (1969) Angiographic findings in 16 patients with juvenile nasopharyngeal angiofibroma. Radiology 92: 279–284CrossRefGoogle ScholarPubMed
Witt, T. R., Shah, J. P., Sternberg, S. S. (1983) Juvenile nasopharyngeal angiofibroma. A 30 year clinical review. American Journal of Surgery 146: 521–525CrossRefGoogle ScholarPubMed