Cruz AAV, Atique JMC, Melo-Filho FV, Elias J. Orbital involvement in juvenile nasopharyngeal angiofibroma: prevalence and treatment.
Ophthalmic Plast Reconstr Surg 2004;
20:296-300. [PMID:
15266144 DOI:
10.1097/01.iop.0000132163.00869.44]
[Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE
To assess the prevalence of orbital invasion by juvenile nasoangiofibroma and to discuss its surgical treatment.
METHODS
A retrospective review of the medical records and tomographic scans of a case series of 19 patients with juvenile nasoangiofibroma was performed. All scans were reviewed by a radiologist and an orbital surgeon. The presence of the tumor was assessed in the pterygopalatine fossa, nasal cavity, nasopharynx, paranasal sinuses, inferior orbital fissure, orbit, and middle cranial fossa.
RESULTS
The most common structures invaded were pterygopalatine fossa (100%), nasal cavity (94.7%), sphenoid sinus (84.2%), and nasopharynx (73.7%). The orbit was invaded in 6 (31.6%) patients. In 5 of these patients, the tumor extended in the orbit through the inferior orbital fissure. Four patients with orbital invasion were successfully operated with the Le Fort I approach.
CONCLUSIONS
Orbital involvement is relatively common in the setting of juvenile nasoangiofibroma extension. The main route of orbital invasion is the inferior orbital fissure. The Le Fort I osteotomy is an adequate approach for managing juvenile nasoangiofibroma when it invades the orbit.
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