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In the 27 cases, the degree of hemorrhaging during excision of the large JNAs varied greatly among individual patients.
Several factors can affect intraoperative blood loss during the removal of JNAs. Liu et al reported that the patient's age, the duration of surgery, and the staging of the lesion significantly influence intraoperative bleeding.
We retrospectively reviewed the cases of 27 patients who experienced intraoperative bleeding during resection of a large (Fisch type III or IV) juvenile nasopharyngeal angiofibroma (JNA).
Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon benign tumour of the adolescent male, with an average age at diagnosis of 15 years.
JNA originates exclusively from the posterolateral wall of the nasal cavity in close proximity to the superior aspect of the sphenopalatine foramen.
Juvenile nasopharyngeal angiofibroma (JNA) is the most common type of benign nasopharyngeal tumor, accounting for 0.5% of all head and neck tumors. Although histologically benign, this tumor is clinically aggressive due to its locally invasive growth and extensions into adjacent anatomic regions.
Many imaging techniques are used to diagnose JNA, beginning with plain film radiographs.
In summary, we conclude that image-guided endoscopic Coblation may be a safe and effective method of resecting intranasal portions of advanced JNAs. Other surgical methods are limited by the complex instrumentation required for adequate debulking and by concerns about frequent and copious intraoperative bleeding.
After embolization was performed on each patient, his JNA was partially ablated via an endoscopic approach with the Coblator II Surgery System with an EVac Xtra Plasma Wand in conjunction with an image-guided navigation system.
On gross examination, JNAs are lobulated, rubbery, tan to purple-red polypoid masses.
In summary, we conclude that the transnasal endoscopic technique is an acceptable approach to the resection of JNAs without extensive lateral extension.
Juvenile nasopharyngeal angiofibroma (JNA) is a benign, highly vascular, and locally invasive tumor.
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