Clinico-Pathological Study of Juvenile Nasopharyngeal Angiofibroma
American Journal of Biomedical and Life Sciences
Volume 8, Issue 4, August 2020, Pages: 91-96
Received: Jun. 15, 2020; Accepted: Jul. 13, 2020; Published: Aug. 4, 2020
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Authors
Asadur Rahman, Department of ENT & Head-neck Surgery, Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh
Kamrul Hasan Tarafder, Department of ENT & Head-neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
MA Matin, Department of ENT & Head-neck Surgery, Rajshahi Medical College, Rajshahi, Bangladesh
Khorsed Alam, Department of ENT & Head-neck Surgery, Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh
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Abstract
Introduction: Anigo-fibroma is vascular swelling arising in the nasopharynx of prepubertal and adolescent males and exhibiting strong tendency to bleed, also termed as nasopharyngeal fibroma or a nasopharyngeal angiofibroma. It accounts for less than 0.5% of all head & neck tumour. It occurs almost exclusively in adolescent male, though rarely found in children and elderly young. It is a rare <1% of head and neck tumors benign mesenchymal neoplasm composed of a vascular proliferation within a cellular, densely collagenizedstroma, typically originating in the nasopharynx, affecting adolescent males. It occurs most often in male adolescents with an average age at diagnosis of 14-16 years. Anyway, there are very few studies, regarding Juvenile Nasopharyngeal Angiofibroma in Bangladrsh and there is not much national data about this issue. Hence, the researcher purposively a total of 30 patients of juvenile nasophryngeal angiofibroma (JNA) included in this study from ENT department of Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh. The aim of this study was to find out the common mode of clinical presentation with their site of extension and different surgical approaches adopted for them. Methods & Materials: This prospective observational study was conducted in the Department of otolaryngology and head, neck surgery of Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh, which is the 2nd generation tertiary level medical service institution during the period from Jan 2017 to Dec 2019. All data were analyzed by using simple statistical data analyzed tools. Result: Almost all the present with recurrent epistaxis 28 (93.33%), following by nasal obstruction 26 (86.66%), nasal discharge 25 (83.33%), facial swelling 10 (33.33%), protrusion of the eyeball 4 (13.33%), aural symptoms 3 (10%) and head-ache 2 (6.66%). Majority of our patient presented with multiple symptoms. Analysis of the finding showed that 100% had nasopharyngeal mass, nasal mass 86.66% palatal bulging 66.66%, swelling of the cheek 33.33%, proptosis 13.33% and headache with blurring of vision 6.66%, these are obtained after thorough clinical examination both local and general. Extension of the tumour assessed on the basis C scan, MRI, as well as observation on the operation showed, nasal cavity 100% and into the pterygopalantine fossa 40%, infratemporal fossa 33.33%, orbit 13.33%, oropharynx 10% maxillary antrum 6.66%, sphenoid sinus 3.33%, ethmoidal sinus 3.33% and 6.66% infra oranial extension. Regarding treatment surgical resection was the most common principal mode of treatment offered to the 93.33% patient but radiotherapy given in 6.66% patient. Conclusion: All young males of this study with nasal obstruction or nose bleed (or both) should be suspected of having juvenile angiofibroma. Angiography to find out feeding vessel to do pre-operative embolization is helpful for surgery. This together with hypotensive anaesthesia and operated by a skilled surgeon having sound knowledge about nasopharynx can lessen the haemorrhage, thereby reduce the mortality and morbidity.
Keywords
Clinico-Pathological, Juvenile, Nasopharyngeal, Angiofibroma
To cite this article
Asadur Rahman, Kamrul Hasan Tarafder, MA Matin, Khorsed Alam, Clinico-Pathological Study of Juvenile Nasopharyngeal Angiofibroma, American Journal of Biomedical and Life Sciences. Vol. 8, No. 4, 2020, pp. 91-96. doi: 10.11648/j.ajbls.20200804.15
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Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Prasad ML, Franchi A, Thompson LDR. Tumours of the nasopharynx: soft tissue tumours: nasopharyngeal angiofibroma. In: El-Naggar AK, Chan JKC, Grandis JR, Takata T., Slootweg PJ, editors. World health organization classification of head and neck tumours. 4. Lyon, France: IARC Press; 2017. pp. 74-75.
[2]
Rekonnen S., Hagstrom J., Vuola J., The changing surgical management of juvenile nasopharyngeal angiofibroma. Eur Arch Otorhinolaryngol 2011; 268: 599-607.
[3]
Hyun DW, Ryu JH, Kim YS. Treatment outcomes of juvenile nasopharyngeal angiofibroma according to surgical approach. Int J. PedOtorhinolaryngol 2011; 75: 69-73.
[4]
Roche PH, Paris J, Regis J, Management of invasive juvenilena sopharyngealangi of ibromas: therole of multimodality approach, Neuro surgery 2007; 61: 768-777.
[5]
Beham A, Beham-Schmid C, Regauer S, Nasopharyngealangiofibroma: true neoplasm or vascular malformation? AdvAnat Pathol 2000; 7: 36-46.
[6]
LiangJ, Yi Z, Lianq P. Then ature of juvenilena sopharyngealangi of ibroma. Otolaryngol Head NeckSurg 2000; 123: 475-481.
[7]
Zhang M., Sun X., Yu H., Biological distinctions between juvenile nasopharyngeal angiofibroma and vascular malformation: an immunohistochemical study. Acta Histochemica 2011; 113: 626-630.
[8]
Chandler RJ Gaulding R., Nasopharyngeal angiofibroma staging and management. Annals of otology. Rhinology and laryngology 1984; 93: 322-329.
[9]
Wilson WR, Miller D., Lee KJ, yules RB, Juvenile nasopharyngeal angiofibroma, Larygoscope 1972; 82: 985.
[10]
Farag MM, Ghanimah SE, Ragaie A, Hormonal receptors in juvenile nasopharyngeal angiofibroma. Laryngoscope1987; 97: 208-211.
[11]
Saylam G., Yucel OT, Sungur A., Proliferation, angiogenesis and hormonal markers in juvenile nasopharyngeal angiofibroma. Int J. Pediatr Otorhinolaryngol 2006; 70: 227-234.
[12]
Yi Z., Fang Z., Lin G., Lin C., Xiao W., Li Z., et al. Nasopharyngeal angiofibroma: A. concise classification system and appropriate treatment options. Am J. Otolaryngol. 2013; 34: 133-41.
[13]
Dr. R. K. Pandey et al, A. Comparative Study of Juvenile Nasal Angiofobroma with other Nasal Masses, IOSR, Journal of Medicine, 2017, pp 32-34.
[14]
Rajat Kumar Dash et al, Juvenile Nasopharyngeal Angiofibroma, Annals of International Medical & Dental Research, 2017, vol (4), pp: 2395-2814.
[15]
Patrocínio JA, Patrocínio LG, Borba BHC, Bonatti BS, Guimarães AHB. Nasopharyngeal angiofibroma in na elderly woman. Am J Otolaryngology. 2005; 26: 198-200.
[16]
Prusty N., Guru RK, Pradhan DK. A. retrospective study on the occurrence and presentation of juvenile nasopharyngeal angiofibroma. Int J Current Res. 2014; 6 (1): 4627-4628.
[17]
Gaillard AL, Anastácio VM, Piatto VB, Maniglia JV, Molina, FD. A. seven-year experience with patients with juvenile nasopharyngeal angiofibroma. Braz. J Otorhinolaryngol. 2010; 76 (2): 245-50.
[18]
Tiwari PK, Teron P., Saikia N., Saikia HP, Bhuyan UT, Das D. Juvenile Nasopharyngeal Angiofibroma: A Rise in Incidence Indian J. Otolaryngol Head Neck Surg. 2016; 68 (2): 141-148.
[19]
Paris J., Guelfucci B., Moulin G., Zanaret M., Triglia JM. Diagnosis and treatment of juvenile nasopharyngeal angiofibroma. Eur Arch Otorhinolaryngol 2001; 258: 120-124.
[20]
Terzian AE. Juvenile Nasopharyngeal Angiofibroma Transantral Microsurgical Approach. A. C. Stamm et al. (eds.), Micro-endoscopic Surgery of the Paranasal Sinuses and the Skull Base© Springer-Verlag Berlin Heidelberg 2000.
[21]
I P Tang, S Shashinder, G Gopala Krishnan, P Narayanan. Juvenile nasopharyngeal angiofibroma in a tertiary centre: ten- year experience. Singapore Med J. 2009; 50 (3): 261-4.
[22]
Mistry RC, Qureshi SS, Gupta S, Gupta S. Juvenile nasopharyngeal angiofibroma: A. single institution study. Indian J Cancer. 2005; 42: 35-9.
[23]
Amin MN, Bhattacharjee N, Juvenile Nasopharyngeal Angiofibroma. Reviwe of 82 cases, journal of college of physician and surgeons 1990; 7: 15-22.
[24]
Alauddin M, Abdullah M, Ahmed K. Juvenile Nasopharyngeal Angiofibroma. A. Reviwe of 135 cases, journal of college of physician and surgeons 1995; 13: 90-94.
[25]
Wanpeng Li, Yang Ni, Hanyu Lu, Li Hu, Dehui Wang, Current Perspectives on the Origin Theory of Juvenile Nasopharyngeal Angiofibroma, Discov Med j, 2019; 27 (150): 245-254.
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