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Abstract：
Background Surgical excision is the primary treatment for juvenile nasopharyngeal angiofibroma (JNA), but this procedure is challenging due to its high vascularity and local aggressiveness. Moreover, preoperative embolization is a subject of debate. Objective The objective of this study is to assess the efficacy, safety, and feasibility of endoscope-assisted excision as a surgical intervention for non-embolized advanced JNA. Materials and methods This case series involved six male patients (mean age: 16 years) with JNA, classified as stages Ⅱc to Ⅲb according to the Radkowski classification. None underwent preoperative embolization. Results Two stage Ⅱc cases underwent total endoscopic endonasal excision. One patient with stage Ⅲa and another with stage Ⅲb underwent surgery via an endoscope-assisted sublabial approach. Two patients, one with stage Ⅱc JNA and another with Ⅲb, underwent a two-stage procedure. Postoperative CT scans showed no residual disease at the six-month mark. On average, each procedure required 1.5 units of blood transfusion. One patient experienced intraoperative bleeding, whereas the remaining patients were free of any major complications. The mean operation duration was 175 minutes per procedure. The mean length of stay at the hospital was 3.75 days per procedure. Conclusion Endoscope-assisted or purely endoscopic approaches can be safely and effectively employed for the complete excision of non-embolized advanced JNAs.
摘要：
背景手术切除是青少年鼻咽血管纤维瘤（JNA）的主要治疗方法，但由于其高血管分布和局部侵略性，该程序具有挑战性。此外，术前栓塞是一个争论的话题。目的本研究的目的是评估疗效，安全,内窥镜辅助切除作为非栓塞性晚期JNA手术干预的可行性。材料与方法本病例系列涉及6名男性JNA患者（平均年龄：16岁），根据Radkowski分类分为Ⅱc至Ⅲb阶段。术前无栓塞。结果2例Ⅱc期患者均行内镜下全鼻孔切除术。1例Ⅲa期患者和1例Ⅲb期患者经内窥镜辅助唇下入路手术。两个病人,一个带有Ⅱc阶段的JNA，另一个带有Ⅲb，进行了两个阶段的手术.术后CT扫描显示六个月时没有残留疾病。平均而言,每个手术需要1.5个单位的输血.一名患者出现术中出血,而其余患者没有任何重大并发症.每个程序的平均手术持续时间为175分钟。每次手术平均住院时间为3.75天。结论内镜辅助或单纯内镜入路可安全有效地用于非栓塞性晚期JNA的完整切除。
