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Clinico-Pathological Study of Juvenile Nasopharyngeal Angiofibroma

Received: 15 June 2020    Accepted: 13 July 2020    Published: 4 August 2020
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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.

Published in American Journal of Biomedical and Life Sciences (Volume 8, Issue 4)
DOI 10.11648/j.ajbls.20200804.15
Page(s) 91-96
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Clinico-Pathological, Juvenile, Nasopharyngeal, Angiofibroma

References
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[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.
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[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.
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[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.
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Cite This Article
  • APA Style

    Asadur Rahman, Kamrul Hasan Tarafder, MA Matin, Khorsed Alam. (2020). Clinico-Pathological Study of Juvenile Nasopharyngeal Angiofibroma. American Journal of Biomedical and Life Sciences, 8(4), 91-96. https://doi.org/10.11648/j.ajbls.20200804.15

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    ACS Style

    Asadur Rahman; Kamrul Hasan Tarafder; MA Matin; Khorsed Alam. Clinico-Pathological Study of Juvenile Nasopharyngeal Angiofibroma. Am. J. Biomed. Life Sci. 2020, 8(4), 91-96. doi: 10.11648/j.ajbls.20200804.15

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    AMA Style

    Asadur Rahman, Kamrul Hasan Tarafder, MA Matin, Khorsed Alam. Clinico-Pathological Study of Juvenile Nasopharyngeal Angiofibroma. Am J Biomed Life Sci. 2020;8(4):91-96. doi: 10.11648/j.ajbls.20200804.15

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  • @article{10.11648/j.ajbls.20200804.15,
      author = {Asadur Rahman and Kamrul Hasan Tarafder and MA Matin and Khorsed Alam},
      title = {Clinico-Pathological Study of Juvenile Nasopharyngeal Angiofibroma},
      journal = {American Journal of Biomedical and Life Sciences},
      volume = {8},
      number = {4},
      pages = {91-96},
      doi = {10.11648/j.ajbls.20200804.15},
      url = {https://doi.org/10.11648/j.ajbls.20200804.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbls.20200804.15},
      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 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.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Clinico-Pathological Study of Juvenile Nasopharyngeal Angiofibroma
    AU  - Asadur Rahman
    AU  - Kamrul Hasan Tarafder
    AU  - MA Matin
    AU  - Khorsed Alam
    Y1  - 2020/08/04
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajbls.20200804.15
    DO  - 10.11648/j.ajbls.20200804.15
    T2  - American Journal of Biomedical and Life Sciences
    JF  - American Journal of Biomedical and Life Sciences
    JO  - American Journal of Biomedical and Life Sciences
    SP  - 91
    EP  - 96
    PB  - Science Publishing Group
    SN  - 2330-880X
    UR  - https://doi.org/10.11648/j.ajbls.20200804.15
    AB  - 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 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.
    VL  - 8
    IS  - 4
    ER  - 

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Author Information
  • Department of ENT & Head-neck Surgery, Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh

  • Department of ENT & Head-neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

  • Department of ENT & Head-neck Surgery, Rajshahi Medical College, Rajshahi, Bangladesh

  • Department of ENT & Head-neck Surgery, Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh

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