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Treatment and prognosis of nasopharyngeal angiofibroma involving the eye and optic nerve

Published online by Cambridge University Press:  04 September 2012

Y Xu ,
G Lin ,
C Lin ,
Z Fang ,
Z Li ,
A Zhou ,
S Lan ,
G Xu  and
Z Yi
Y Xu
Affiliation:
Department of ENT, Otolaryngology Institute of Fujian Province, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
G Lin
Affiliation:
Department of ENT, Otolaryngology Institute of Fujian Province, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
C Lin
Affiliation:
Department of ENT, Otolaryngology Institute of Fujian Province, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
Z Fang
Affiliation:
Department of Imaging, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China Institutional Review Board of the Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
Z Li
Affiliation:
Department ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China Institutional Review Board of the Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
A Zhou
Affiliation:
Department ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China Institutional Review Board of the Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
S Lan
Affiliation:
Department ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China Institutional Review Board of the Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
G Xu
Affiliation:
Department Ophthalmology, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China Institutional Review Board of the Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
Z Yi*
Affiliation:
Department of ENT, Otolaryngology Institute of Fujian Province, First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
*
Address for correspondence: Dr Zixiang Yi, Department of ENT, First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China Fax: +86 591 87982780 E-mail: [email protected]
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Abstract

Objective:

To discuss the minimally invasive treatment and prognosis of juvenile nasopharyngeal angiofibroma involving the eye and optic nerve.

Methods:

Retrospective analysis of clinical data for 18 large juvenile nasopharyngeal angiofibromas, with reports of three typical cases.

Results:

The tumour invaded the orbit, eye, optic nerve and optic chiasm in 18, 9, 8 and 5 patients, respectively. Twelve patients were cured after surgery, with the affected eye and vision essentially returning to normal. In six patients, tumour residue was found in the middle cranial fossa; two of these six did not return for follow up. Four patients underwent radiotherapy; all four regained placement of the eye in a normal or near-normal position. One of these four patients regained normal visual acuity, two experienced no improvement in visual acuity, and one became blind.

Conclusion:

In patients with this tumour, surgery may return the eye to the normal position and may restore visual acuity if the optic fundus, macula, retina and optic nerve are only mildly affected. Modern radiotherapy can treat the intracranial residue effectively. A combined approach via the antrum, infratemporal fossa and nasal cavity, using a Caldwell–Luc incision, provides minimally invasive surgical access.

Keywords

NasopharynxAngiofibromaEyeOptic NervePathology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 11 , November 2012 , pp. 1108 - 1113
Copyright
Copyright © JLO (1984) Limited 2012

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References

1 Radkowski, D, McGill, T, Healy, GB, Ohlms, L, Jones, DT. Angiofibroma changes in staging and treatment. Arch Otolaryngol Head Neck Surg 1996;122:122–9CrossRefGoogle ScholarPubMed
2 Stern, RM, Beauchamp, GR, Berlin, AJ. Ocular findings in juvenile nasopharyngeal angiofibroma. Ophthal Surg 1986;17:560–4Google ScholarPubMed
3 Cruz, AA, Atique, JM, Melo-Filho, FV, Elias, J Jr. Orbital involvement in juvenile nasopharyngeal angiofibroma: prevalence and treatment. Ophthal Plast Reconstr Surg 2004;20:296–300 CrossRefGoogle ScholarPubMed
4 Watnick, RL, Trobe, JD. Bilateral optic nerve compression as a mechanism for the Foster Kennedy syndrome. Ophthalmology 1989;96:1793–8CrossRefGoogle ScholarPubMed
5 Salcone, EM, Pepin, SM. Intermittent esotropia as the initial presentation of juvenile nasopharyngeal angiofibroma. J AAPOS 2004;8:201–3CrossRefGoogle ScholarPubMed
6 Liang, J, Yi, ZX, Liang, P. The nature of juvenile nasopharyngeal angiofibroma. Otolaryngology Head Neck Surg 2000;123:475–81CrossRefGoogle ScholarPubMed
7 Wu, AW, Mowry, SE, Vinuela, F, Abemayor, E, Wang, MB. Bilateral vascular supply in juvenile nasopharyngeal angiofibromas. Laryngoscope 2011;121:639–43CrossRefGoogle ScholarPubMed
8 Yi, ZX, Li, ZC, Lin, CC, Ye, S. Huge lobulated juvenile angiofibroma: sites of extension and selection of procedures for management. J Otolaryngol 2003;32:211–16Google ScholarPubMed
9 Yi, ZX, Li, ZC, Cheng, JM, Zhang, R, Lin, C, Zhou, AD et al. Huge nasopharyngeal angiofibroma with intracranial extension: change in the dura mater and choice of surgical management. J Laryngol Otol 2007;121:1108–12CrossRefGoogle ScholarPubMed
10 Lin, C, Li, ZC, Cheng, JM, Lin, GB, Zhou, AD, Yi, ZX. Pathological features and clinical management of nasopharyngeal angiofibroma [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2008;43:763–6Google ScholarPubMed
11 Yi, ZX, Huang, J, Lin, Chang, Lin, Cong, Lin, G, Li, ZC, et al. Modern radiation treatment of nasopharyngeal angiofibroma of postoperative residual. Chin J Otorhinolaryngol Head Neck Surg 2010;45:427–8Google Scholar