Endoscopic Surgery for Juvenile Nasopharyngeal Angiofibroma

| Posted in: Science Health Sciences

Journal name: The Malaysian Journal of Medical Sciences
Original article title: Endoscopic Sinonasal Surgery in the Management of Juvenile Nasopharyngeal Angiofibroma
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

This page is merely a summary which is automatically generated hence you should visit the source to read the original article which includes the author, publication date, notes and references.

Author:

Shahid Hassan Mohammad Hamzah


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Endoscopic Sinonasal Surgery in the Management of Juvenile Nasopharyngeal Angiofibroma

Year: 2000

Copyright (license): CC BY 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

Juvenile nasopharyngeal angiofibroma (JNA) is a rare, locally malignant yet histologically benign tumor primarily affecting adolescent males, accounting for 0.5-1% of head and neck tumors. Its prevalence is notably higher in Southeast Asia, with common symptoms including epistaxis and intranasal obstruction. The etiology of JNA remains unclear despite several proposed histogenic concepts, and controversy over its management persists worldwide, with surgery generally being the treatment of choice. However, the risk of surgery has fostered alternative treatment modalities, such as radiation, chemotherapy, and superselective embolization (SSE), which has significantly reduced the need for blood transfusion even in advanced tumor cases.

Efficacy of Endoscopic Sinonasal Surgery (ESS)

One significant development in the management of JNA is the introduction of endoscopic sinonasal surgery (ESS) as a technique for surgical removal. Although literature on ESS for JNA remains limited, a report documenting its application in Malaysia presents promising results. Following preoperative superselective embolization, ESS proved effective in navigating the tumor’s intricate anatomy, thereby facilitating the identification of residual tags and the tumor's site of origin. This approach is particularly beneficial for small to moderate-sized tumors and is posited to decrease the recurrence rate typically observed with other surgical techniques. The report emphasizes that ESS could be a viable combined surgical approach, enhancing the overall management of JNA.

Conclusion

Overall, current insights into the management of juvenile nasopharyngeal angiofibroma indicate a shift towards less invasive methods such as endoscopic surgeries, when combined with preoperative techniques like SSE. The evolving understanding of surgical interventions for JNA not only constitutes a significant advancement in treatment methodologies but also potentially leads to better patient outcomes with fewer complications. Further studies and reports are necessary to solidify the efficacy of ESS and broaden its application in the context of JNA, while ongoing exploration into the tumor's etiology and histogenesis may ultimately provide clearer pathways for prevention and treatment in affected populations.

FAQ section (important questions/answers):

What are the common symptoms of Juvenile Nasopharyngeal Angiofibroma (JNA)?

JNA typically presents with symptoms such as epistaxis (nosebleeds) and intranasal obstruction, particularly in adolescent males. Its histological benignity contrasts with its locally malignant behavior.

What are the treatment options available for JNA?

Surgery is the primary treatment for JNA, but other modalities like radiation and chemotherapy are often considered. Superselective embolization (SSE) has improved preoperative management, reducing the need for blood transfusions.

How effective is SPECT in diagnosing lumbar spine lesions?

SPECT outperformed plain radiography and planar bone scintigraphy, detecting lesions in 38.1% of patients compared to 28.6% and 14.3%, respectively. This indicates SPECT's superior ability to identify patients with chronic low back pain.

What findings were noted regarding difficult intubation in this study?

The study found a difficult intubation incidence of 2.8%, with significant correlations between Mallampati class, short neck features, and intubation difficulties. This suggests these factors can help predict challenges in intubation.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Endoscopic Surgery for Juvenile Nasopharyngeal Angiofibroma”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Chemotherapy:
Chemotherapy refers to the use of drugs to treat cancer by inhibiting the growth of rapidly dividing cells. It is often associated with significant side effects, including nausea and vomiting, which need to be managed to improve patient quality of life. Research continues to explore effective antiemetic strategies during chemotherapy treatment.

2) Study (Studying):
A study is a systematic investigation aimed at discovering or verifying facts. In medical research, studies, such as the randomized double-blind trials mentioned, assess treatment effectiveness or patient outcomes. Through rigorous methodological processes, studies provide evidence that informs clinical practices, therapies, and healthcare policies, advancing knowledge in medicine.

3) Science (Scientific):
Science is the systematic enterprise that builds and organizes knowledge in the form of testable explanations and predictions about the universe. In medicine, scientific methods enable clinicians to observe, experiment, and validate treatments and interventions, fostering advancements in medical practice, such as the techniques for treating conditions like JNA.

4) Pain (Paiṇ):
Pain is a distressing sensory and emotional experience typically caused by tissue damage or injury. Effective pain management is crucial in various medical settings, particularly postoperatively, where preemptive analgesia strategies, like the administration of ketamine or fentanyl, are explored to alleviate discomfort and enhance recovery for surgical patients.

5) Repair:
Repair refers to the process of restoring something to a good or functional condition. In medical contexts, particularly in surgeries involving congenital anomalies or injuries, repair techniques, such as cleft lip and palate surgeries, play a critical role in improving patient outcomes and quality of life, often requiring multidisciplinary approaches.

6) Maci (Mācī):
Machi likely refers to a geographical or cultural aspect, possibly indicating a location associated with medical practice or research. The phrase may not directly connect with conventional medical terms, but place names often signify the origin of studies, clinical trials, or specific healthcare practices relevant to regional health issues.

7) Reason:
Reason refers to the rationale or underlying explanation for an action or condition. In medical research, understanding the reasons behind symptoms, disease progression, or treatment choices informs patient management strategies, allowing healthcare providers to tailor interventions to individual patient needs and improve overall health outcomes.

8) Male (Mālē):
Male refers to the biological sex commonly associated with higher levels of testosterone and specific anatomical features. In medical research, such as studies comparing conditions like juvenile nasopharyngeal angiofibroma, understanding gender prevalence helps identify risk factors, inform treatment approaches, and improve health outcomes tailored to male patients.

9) Radiotherapy:
Radiotherapy is a treatment modality that utilizes high-energy radiation to kill cancer cells and shrink tumors. It often accompanies chemotherapy in treatment regimens for various cancers. Effective radiotherapy protocols are essential for patient care; ongoing research assesses its effectiveness, safety, and potential side effects faced by patients undergoing treatment.

10) Edema (Oedema):
Oedema is the medical term for swelling caused by excess fluid trapped in the body's tissues. It is often a side effect of various medical treatments or a symptom of underlying health issues. Identifying and managing oedema is crucial in surgical recovery and in patients with chronic health conditions.

11) Raja (Rāja, Rājā):
Raja is a term that can denote a title or role, often suggesting authority or leadership within cultural or geographical contexts. In medical literature or reports, individuals with specific titles may conduct or contribute to research, furthering understanding of clinical practices and innovations in healthcare across different regions.

12) Observation:
Observation in medical settings involves attentively monitoring patients' conditions, treatments, and responses over time. It is fundamental for assessing the effectiveness of interventions, adapting care strategies, and identifying potential complications, thereby ensuring optimal patient management throughout various medical procedures and focusing on continuous improvement.

13) Controversy:
Controversy in medicine often arises from differing opinions on treatment modalities, interpretations of research, or clinical practices. Engaging in controversial discussions drives innovation, encourages critical thinking among clinicians, and stimulates further research to resolve disagreements, particularly significant in the management of complex conditions like juvenile nasopharyngeal angiofibroma.

14) Practising (Practicing):
Practising refers to the act of engaging in a profession, especially in the context of medicine. Practising clinicians apply their knowledge to treat patients, conduct research, and improve healthcare. Continuous professional development in medical practices is essential to enhance treatment efficacy, maintain standards, and adapt to advances in medical knowledge.

15) Knowledge:
Knowledge encompasses the information, understanding, and skills acquired through experience or education. In medicine, expanding knowledge through studies and clinical practice is vital for evidence-based decision-making. Knowledge informs treatment protocols, enhances patient care, and drives innovation, ensuring healthcare professionals are equipped to provide the best possible outcomes.

16) Vomiting:
Vomiting is the expulsion of stomach contents through the mouth and is a common symptom during various medical treatments, especially chemotherapy. Managing vomiting effectively is crucial for patient comfort and adherence to treatment regimens. Research into antiemetic strategies, including ondansetron, helps improve patient experiences during cancer therapies.

17) Activity:
Activity encompasses physical, mental, or functional actions undertaken by patients or healthcare providers. In recovery and rehabilitation contexts, understanding patient activity levels assists in designing treatment plans that promote healing and improve health outcomes. Regular assessment ensures interventions align with patient capabilities and enhances overall well-being.

18) Relative:
Relative in medical contexts often describes comparisons between treatments, symptoms, or conditions. Understanding relative efficacy and risks helps clinicians make informed decisions about patient care. It also applies to evaluating individual patient factors in treatment planning, emphasizing the importance of personalized approaches to healthcare and optimal management.

19) Account:
Account refers to the recording or report of an event, observation, or outcome. In healthcare, maintaining accurate medical records or accounts of patient interactions is critical for continuity of care, legal documentation, and facilitating communication among healthcare providers, ultimately contributing to improved patient safety and quality of services.

20) Nausea:
Nausea is the unpleasant sensation of needing to vomit, commonly associated with various conditions, including postoperative recovery and chemotherapy. Effective management of nausea through medications and supportive care is essential for enhancing patient quality of life and ensuring adherence to treatment protocols, significantly impacting overall health outcomes.

21) Sharman (Śarma, Sarmā, Sarma, Sharma, Śarman):
Sharma may refer to a researcher or clinician involved in medical studies or reports. Names in academic articles often indicate contributors who have provided insights or findings relevant to a field. Recognizing their work helps attribute knowledge advancements and encourages future research efforts in healthcare practices and treatments.

22) Field:
Field denotes a specific area of study or professional practice. In the context of medical research, various fields address distinct health issues, treatment modalities, or patient care approaches. Understanding diverse fields enhances interdisciplinary collaboration, promotes comprehensive patient management, and leads to more effective healthcare solutions and innovations.

23) Birth:
Birth refers to the process of bringing forth offspring and is associated with numerous healthcare considerations, particularly in pediatrics and congenital conditions. Understanding birth-related factors helps in managing congenital anomalies effectively and highlights the importance of early intervention and comprehensive care for affected infants and families.

24) Blood:
Blood is a vital fluid that circulates in the body, transporting nutrients, oxygen, and waste products. In medical contexts, understanding blood's role is crucial for diagnosing and managing conditions. Blood transfusions and the management of blood-related issues, such as anemia or bleeding after surgery, are significant considerations in patient care.

25) Life:
Life encompasses the biological and physiological processes that characterize living organisms. In medicine, understanding life involves a focus on health promotion, disease prevention, and the enhancement of quality of life through effective treatments and therapies. Improving the overall health of individuals is a primary goal of healthcare systems.

26) Fear:
Fear is an emotional response to perceived threats or danger, which can significantly impact health behavior and treatment adherence. In medical settings, addressing patients' fears related to procedures or diagnoses is essential for achieving positive outcomes, as providing reassurance and clear information can alleviate anxieties surrounding healthcare experiences.

27) Wall:
Wall may refer to anatomical structures involved in various medical procedures, particularly in surgery and diagnostics. In specialties focusing on confinement or barriers within the body, knowledge of walls, such as those of organs or cavities, is crucial for understanding conditions and planning effective interventions for patient treatment.

28) Post:
Post indicates the period following a specific event, commonly in reference to postoperative care after surgical procedures. Effective post-surgical management is vital for patient recovery, addressing potential complications, and enhancing the overall healing process, thereby improving patient outcomes and quality of life following medical interventions.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘Endoscopic Surgery for Juvenile Nasopharyngeal Angiofibroma’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Japan, Daily activities, Acute pain, Saline Group, Blood transfusion, Surgical approaches, Foreign body, Therapeutic value, Short neck, Spinal Cord, Long-term treatment, South East Asia, Statistical Significance, Pain intensity assessment, Randomized study, Visual analogue scale, Treatment modality, Congenital Anomalies, Placebo controlled study, Prospective study, Randomized double-blind, Surgical approach, Magnetic resonance imaging, Chronic back pain, Intensive care unit, Double blind placebo controlled study, Chronic low back pain, Double blind, Postoperative Pain, Success rate, Granuloma formation, Lumbar spine, Congenital deformities, Treatment approach, Multidisciplinary team, Patient controlled epidural analgesia, Critically ill patients, Difficult intubation, Respiratory failure, Analgesic consumption, Randomised double blind study, Treatment of choice, Preemptive analgesia, Intravenous ketamine, Effective analgesia, Fentanyl, Nasolacrimal duct obstruction, Continuous infusion, Chemotherapy regimen, Local population, Cleft lip and palate, Head and neck tumours, Single Photon Emission Computed Tomography, Plain radiograph, Flexible fiberoptic bronchoscopy, Chemotherapy-induced emesis, Conventional approach, Collapsed lung, Gynaecological surgery, External approach, Postoperative pain intensity, Presenting symptom, Mallampati score, Intravenous fentanyl, Ketamine, Common presenting symptom, Young adolescent, Anatomical area, Therapeutic reasons, Fentanyl group.

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