Current trend of surgery in juvenile nasopharyngeal angiofibroma: a hospital based retro-prospective study

Background: The aim of the present study was to know the current trends of surgery, to determine the surgery of choice according to stage and complications, rate of recurrence of following surgery. Methods: Retro-prospective study was carried out from August 2004 to July 2014, in which 31 prospective and 8 prospective cases were included. All the details of patients like general examination, ENT examination, computed tomography or magnetic resonance imaging scan finding, staging, and approach of surgery, complications, and recurrence rate were recorded. Results: In our study all the patients were male and the mean age was 15.74 years (age ranged 11 to 22 years). Most frequent sign and symptoms were epistaxis (92.4%), nasal blockage (90%), and facial swelling (18%). Most common surgical approach was ‘trans palatine approach’ (51% cases) belongs to stage IIa, IIb, IIc, IIIa, IIIb and ‘lateral rhinotomy approach’ used in 35% cases. And by endoscopic approach (only 5.1% cases) were operated due to lack of embolization technique. Overall recurrence was about 29% (66% cases belonged to stage III). Postoperative complications were septal perforation 33%, palatal perforation 9.5%, facial disfiguration 9.5% and 9.5% hypertrophic scar. Conclusions: Our study we concluded that, 92% of patients age group 11 to 20 years and all were males. Epistaxis and nasal obstruction were the most common symptoms. Most of the recurrent tumor belonged to stage III tumor. Most appropriate surgical approach for stage I, IIa and IIb was transpalatine approach and for stage IIc and IIIa was lateral rhinotomy. Complete excision of intracranial extension of tumor was difficult and causes recurrence of diseases.