A Comparison of Outcomes of Various Approachs for Resection of Juvenile Nasopharyngeal Angiofibroma at Our Tertiaty Care Center: A Clinical Study

Background: Nasopharyngeal angiofibroma is benign but locally aggressive, slow growing vascular tumor which primarily affects adolescent male. Traditionally, these tumors have been removed by open surgical approaches. While minimal surgical approaches are accompanied by high rates of residual or recurrent lesions, expanded external approaches may result in facial growth disturbance in children in addition to cosmetic and functional complications. Now trend changed towards endoscopic approach for limited angiofibroma extension. AIMS AND OBJECTIVES: To evaluate Age distribution, common presenting features, to decide surgical technique according to stage& to study Outcomes of various approaches. Methods: This is a prospective study of twenty five patients with angiofibroma without intracranial extension treated by external and endoscopic approach in our tertiary care referral center. The study duration was from July 2015 to July 2018. Twenty five patients with complete clinical data were identified and included in the study after thorough investigation. Results: 5 (20 %) out of 25 patients were operated with Trans palatal approach among which 1 patient develop palatal dehiscence.10 (40 %) out of 25 patients were operated with lateral rhinotomy approach and post operatively 1 patient developed hypoesthesia of cheek.10 (40 %) patients underwent Trans nasal endoscopic approach among which 1 patient developed nasal synechiae and 1 patient had recurrence. Post-operative nasal endoscopy findings and radiological findings confirmed this fact. Conclusions: most common affected gender is male with adolescent group. Patients of angiofibroma mostly presented with chief complain of nasal bleeding and obstruction. Transnasal endoscopic approach is preferred over external approach in early stages due to less morbidity and direct visualization of tumor with feeding vessel.21 (84 %) out of 25 patients are complete disease free without any complication.