Management of persistent juvenile angiofibroma after endoscopic resection: Analysis of a single institution series of 74 patients

Head Neck. 2019 May;41(5):1297-1303. doi: 10.1002/hed.25555. Epub 2018 Dec 10.

Abstract

Background: Management of persistent juvenile angiofibroma (pJA) after transnasal endoscopic resection is controversial. To better understand its behavior, optimize treatment, and minimize morbidity, we report our experience in pJA focusing on follow-up strategies and disease progression.

Methods: A retrospective review of clinical records of all JA cases treated with endoscopic surgery at the Unit of Otorhinolaryngology of the University of Brescia between January 1994 and October 2015 was performed.

Results: Seventy-four cases were included. Mean follow-up was 113 months (6-266 months). Evolution of pJA was analyzed in 6 cases. Residual lesion size significantly decreased in 3 cases and 2 lesions did not show size variations; significant growth was detected in 1 case of intentional pJA, with diameter increasing by 2.2 mm/yr.

Conclusions: pJAs may have the tendency to regress spontaneously or remain stable. In selected cases, avoiding treatment of nongrowing pJA in critical areas is a prudent option.

Keywords: endoscopic surgery; juvenile angiofibroma; magnetic resonance imaging; persistence; revision surgery.

MeSH terms

  • Adolescent
  • Adult
  • Angiofibroma / diagnostic imaging
  • Angiofibroma / mortality
  • Angiofibroma / pathology
  • Angiofibroma / surgery*
  • Child
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Hospitals, University
  • Humans
  • Italy
  • Linear Models
  • Magnetic Resonance Imaging / methods
  • Male
  • Mouth
  • Nasopharyngeal Neoplasms / diagnostic imaging
  • Nasopharyngeal Neoplasms / mortality
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / surgery*
  • Natural Orifice Endoscopic Surgery / methods*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Neoplasm, Residual / pathology
  • Neoplasm, Residual / surgery
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome
  • Young Adult