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Patterns of vascularization and surgical morbidity in juvenile nasopharyngeal angiofibroma: A case series, systematic review, and meta-analysis
- Source :
- Head & Neck. 40:428-443
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- Background Vascular patterns of juvenile nasopharyngeal angiofibroma (JNA) are poorly defined. We performed both institutional and systematic literature reviews to characterize the relationship between arterial supply patterns of JNA with intraoperative blood loss and tumor recurrence. Methods A retrospective review of 26 patients with JNA treated at our institution from 1995 to 2015 with available angiograms, and systematic reviews and meta-analyses of 828 JNA cases undergoing angiographic embolization published between 1995 and 2015 were completed per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results The systematic review (828 cases) found internal carotid artery (ICA) supply in 35.6% of tumors, and 30.8% of tumors received bilateral vascular supply. Our institutional data (n = 26) indicated 69% had bilateral supply. Meta-analysis of data from 5 studies demonstrated ICA/bilateral arterial supply is predictive of increased operative blood loss (P < .01). Conclusion Complex vascular contributions to JNA are frequent, underreported, and portends increased blood loss. This information can justifiably be included in staging systems to enhance prognostic counseling of patients.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Juvenile nasopharyngeal angiofibroma
medicine.medical_treatment
Blood Loss, Surgical
Angiofibroma
Young Adult
03 medical and health sciences
0302 clinical medicine
medicine.artery
medicine
Humans
Embolization
Child
030223 otorhinolaryngology
Neoplasm Staging
Retrospective Studies
medicine.diagnostic_test
business.industry
Angiography
Nasopharyngeal Neoplasms
Embolization, Therapeutic
Surgical morbidity
Tumor recurrence
Surgery
Systematic review
Otorhinolaryngology
Meta-analysis
Radiology
Internal carotid artery
business
Carotid Artery, Internal
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 10433074
- Volume :
- 40
- Database :
- OpenAIRE
- Journal :
- Head & Neck
- Accession number :
- edsair.doi.dedup.....fae62698df1ba6b0289406e481c02915