Angiofibromy nosohltanu

Angiofibromas of the Nasopharynx

The objective of the study was to evaluate the classification, therapeutic proceduresand therapeutic results in patients with angiofibroma of the nasopharynx. The study was retrospective, all results of preoperative imaging methods (CT and/or MR) were for the purpose of classification re-evaluated by one doctor. In the trial patients were included where the minimal follow upperiod was 12 months. The group comprised 22 patients operated in 1989-1999. Three patients ofthis group were operated on account of a relapse. The group comprised men aged 14-36 years, themean being 22 years. Radiological staging according to Chandler was used. The therapeutic resultswere evaluated on the basis of diagnostic imaging during the postoperative period. In all patientsCT was used and/or MR within the 7th postoperative day to rule out or confirm a residual tumour.A relapse of a tumour was diagnosed in patients without a postoperative residue where during thesubsequent follow up a relapse of a tumour was proved by an imaging method.The group did not comprise any patients with radiological classification I, five patients wereclassified as stage II, fourteen had classification III and three patients classification IV. In 18patients preoperative embolization of the afferent vessels was made. In all patients on surgery theapproach was via medial maxillectomy by incision from lateral rhinotomy, in one patient thisapproach was combined with the orbitozygomatic approach. In 18 patients (82 %) the operation wasradical, i.e. without a detectable residue after surgery. Patients with a residue were carefullyradiologically monitored, in one patient progression of the disease occurred and he was indicatedfor irradiation with Leksell’s gammaknife. In three patients a relapse of the disease developed. Therelapses were treated by surgery, in one patient in combination with irradiation with Leksell’sgammaknife. The residues and relapses were found in patients with tumours in the more advancedstages, i.e. III and IV.

Key words:
angiofibroma, embolization, surgery, classification.