Juvenile nasopharyngeal angiofibroma - clinical profile and analysis of recurrence.

Juvenile nasopharyngeal angiofibroma (JNA) is a fibrous and vascular tumour that commonly involves the nasopharynx. It accounts for < 0.5% of head and neck tumours and primarily affects male adolescents. It is a nonencapsulated, submucosal spreading tumour which is locally destructive. Originating from the superior posterior margin of the sphenopalatine foramen, progression of the tumour is often slow with extension into the pterygopalatine fossa, the paranasal sinus or infratemporal fossa. * The most common presenting symptoms were epistaxis and nasal obstruction in both primary and secondary cases. * More advanced disease was observed in younger patients and in those who had a longer duration of epistaxis. * Intra-operative blood loss was significantly higher in patients with more advanced disease. * There was no effect of pre-operative embolization on intra-operative blood loss. * The blood loss was significantly higher in patients who underwent surgery by the combined transpalatal and sublabial approach compared with the lateral rhinotomy approach. The mean (SD) symptom free interval following previous surgery was 11.3 (10.82) months in secondary cases. * Younger patients had a tendency for recurrence. * There was no association between embolization and recurrence in both primary and secondary cases. * The rate of recurrence was higher with the combined transpalatal and sublabial approach when compared to the lateral rhinotomy approach.