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https://hdl.handle.net/2440/61852
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Type: | Journal article |
Title: | A new endoscopic staging system for angiofibromas |
Author: | Synderman, C. Pant, H. Carrau, R. Gardner, P. |
Citation: | Archives of Otolaryngology: Head and Neck Surgery, 2010; 136(6):588-594 |
Publisher: | Amer Medical Assoc |
Issue Date: | 2010 |
ISSN: | 0886-4470 1538-361X |
Statement of Responsibility: | Carl H. Snyderman, Harshita Pant, Ricardo L. Carrau and Paul Gardner |
Abstract: | Objective: To develop a new staging system for juvenile nasopharyngeal angiofibroma that reflects changes in surgical approaches (endonasal), route of intracranial extension, and the extent of vascular supply from the internal carotid artery. Design: Retrospective review of case series. Setting: Academic medical center. Patients: Patients undergoing endoscopic endonasal surgery for juvenile nasopharyngeal angiofibroma at the University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, from 1998 through 2008. Intervention: Patients were staged according to current systems and compared with a new staging system that also incorporated the route of skull base extension and tumor vascularity. Main Outcome Measures: Estimated blood loss, number of operations, and tumor recurrence. Results: Skull base erosion was observed in 74% of cases. Following embolization of external carotid artery tributaries, residual vascularity from the internal carotid artery was seen in 51% of patients. Residual vascularity, classified as UPMC stage IV and V, strongly correlated with blood loss, requirement for multiple procedures, and residual or recurrent tumor. Conclusions: Tumor size and extent of sinus disease are less important in predicting complete tumor removal with endonasal surgical techniques. The UPMC staging system for juvenile nasopharyngeal angiofibroma accounts for 2 important prognostic factors, route of cranial base extension, and vascularity and is applicable to endoscopic or open approaches. Compared with other staging systems, the UPMC staging system provides a better prediction of immediate morbidity (including blood loss and need for multiple operations) and tumor recurrence. |
Keywords: | Skull Base Carotid Artery, Internal Humans Angiofibroma Nasopharyngeal Neoplasms Endoscopy Neoplasm Staging Prognosis Retrospective Studies Adolescent Male |
Rights: | © 2010 American Medical Association. All rights reserved. |
DOI: | 10.1001/archoto.2010.83 |
Published version: | http://dx.doi.org/10.1001/archoto.2010.83 |
Appears in Collections: | Aurora harvest Surgery publications |
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