Endoskopik juvenil nazofarengeal anjiofibrom cerrahisi - Uludağ KBB sonuçları
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Date
2011-03-17
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Uludağ Üniversitesi
Abstract
Bu çalışmanın amacı Juvenil Nazofarengeal Anjiofibrom (JNA)’un cerrahisinde endoskopik yaklaşımla tedavi edilen olgu serisinin sonuçlarını ortaya koymaktır. Geriye dönük olarak 1995 ile 2010 yılları arasında ve Uludağ Üniversitesi Kulak Burun Boğaz Anabilim Dalı’nda JNA nedeniyle tedavi edilen toplam 18 hasta incelendi. Nisan 2007 – Mart 2010 tarihleri arasında endoskopik olarak rezeksiyon uygulanan 6 hasta değerlendirmeye alındı. Tanı, fizik muayene bulguları ve radyolojik bulgular ile konuldu. Tüm hastalara cerrahiden 24 saat öncesinde selektif anjio-embolizasyon uygulandı. Hastaların yaşları 14 ile 21 arasında değişmekte olup tümü erkekti. Hastalar en sık burun tıkanıklığı (6/6 %100) ve burun kanaması (5/6 %83) semptomlarıyla kliniğimize başvurdu. Beş hastada endoskopik yaklaşımla eksizyon uygulandı. Bir hastada endoskopik ve transmaksiller yaklaşımlar kombine edildi. Bir hastada yineleme görüldü. Radyolojik olarak saptanan yinelemede büyüme ve semptom olmadığı için hasta takip edilmektedir. Postoperatif dönemde hiçbir hastada cerrahiye veya embolizasyona bağlı komplikasyon gelişmedi. JNA tedavisinde endoskopik yaklaşım, preoperatif embolizasyon uygulanması halinde güvenle uygulanabilecek bir yöntemdir. Endoskopik yaklaşım hasta morbiditidesini önemli ölçüde azalttığından öncelikle seçilecek tedavi yöntemi olmalıdı
The aim of this study is to evaluate the outcomes of patients with JNA who underwent endoscopic approach surgery. 18 patients who were treated for JNA between 1995 and 2010 at Uludag University (ENT Department ) were retrospectively analyzed. Between April 2007 and March 2010, 6 of these patients who underwent endoscopic resection, were evaluated. Diagnosis of these patients was set by the physical examination and radiological findings. All patients underwent selective angiography-embolization 24 hours prior the surgery. All patients were male and their ages varies between 14 to 21. The majör complaints of the patients were nasal obstruction (6/6, 100%) and epistaxis (5/6, 83%). 5 patients underwent endoscopic approach only to remove the tumor.In only one patient a combination of endoscopic and transmaxillary approach was performed. After primary surgery recurrence was noticed in one patient. No further management was required for that patient because there are no radiologically progressive growth and any symptoms. In the postoperative period, none of the patients had any complications related to surgery or embolism. The endoscopic approach in JNA treatment is a safe method if the preoperative embolization is performed. Since the endoscopic approach significantly reduces the morbidity of patients, this treatment should be prefered as first choice.
The aim of this study is to evaluate the outcomes of patients with JNA who underwent endoscopic approach surgery. 18 patients who were treated for JNA between 1995 and 2010 at Uludag University (ENT Department ) were retrospectively analyzed. Between April 2007 and March 2010, 6 of these patients who underwent endoscopic resection, were evaluated. Diagnosis of these patients was set by the physical examination and radiological findings. All patients underwent selective angiography-embolization 24 hours prior the surgery. All patients were male and their ages varies between 14 to 21. The majör complaints of the patients were nasal obstruction (6/6, 100%) and epistaxis (5/6, 83%). 5 patients underwent endoscopic approach only to remove the tumor.In only one patient a combination of endoscopic and transmaxillary approach was performed. After primary surgery recurrence was noticed in one patient. No further management was required for that patient because there are no radiologically progressive growth and any symptoms. In the postoperative period, none of the patients had any complications related to surgery or embolism. The endoscopic approach in JNA treatment is a safe method if the preoperative embolization is performed. Since the endoscopic approach significantly reduces the morbidity of patients, this treatment should be prefered as first choice.
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Keywords
Juvenil nazofarengeal anjiofibrom, Endoskopi, Preoperatif embolizasyon, Juvenile nasopharyngeal angiofibroma, Pre-operative embolization, Endoscopy
Citation
Kasapoğlu, F. vd. (2011). ''Endoskopik juvenil nazofarengeal anjiofibrom cerrahisi - Uludağ KBB sonuçları''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 37(1), 7-11.