Summary
Objective
The juvenile nasopharyngeal angiofibroma (JNA) is a benign neoplasm that affects mostly
young males. Preoperative embolisation is an accepted treatment to reduce perioperative
bleeding, however, severe complications may accompany these invasive procedures.
Case report
One 14-year-old JNA patient with severe epistaxis was transferred to us for treatment.
Unfortunately, a left middle cerebral artery infarction occurred during the embolisation
procedure. Right side hemiplegia and left eye blindness were noted. Nine months later,
another course of embolisation and surgical treatment was performed, but the presence
of one oronasal fistula was noted after the JNA was successfully excised. A free radial
forearm flap was selected to reconstruct the palate.
Conclusion
Angiography and embolisation carry the risks of accidental infarction. Oronasal fistula
may occur when incising through the ‘embolized palate’. Possible complications should
be discussed with the families in advance. In the case of complications, the medical
team should cooperate and try to prevent morbidity.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Endoscopic resection of nasopharyngeal angiofibroma by combined transnasal and transoral routes.Am J Otolaryngol. 2003; 24: 149-154
- Surgical approach to juvenile nasopharyngeal angiofibroma.J Craniomaxillfac Surg. 2006; 34: 3-8
- Long-term results of radiation therapy for juvenile nasopharyngeal angiofibroma.Am J Otolaryngol. 2001; 22: 172-175
- Anesthetic management of juvenile nasopharyngeal angiofibroma resection.J Cardiothorac Vasc Anesth. 2003; 17: 622-624
- Exclusively endoscopic removal of juvenile nasopharyngeal angiofibroma.Arch Otolaryngol Head Neck Surg. 2002; 128: 928-935
- A rare complication of embolization in juvenile nasopharyngeal angiofibroma.Int J Pediatr Otorhinolaryngol. 2005; 69: 423-428
- Endoscopic surgery in treatment of juvenile nasopharyngeal angiofibroma.Int J Pediatr Otorhinolaryngol. 2003; 67: 1219-1225
- Angiofibroma, changes in staging and treatment.Arch Otolaryngol Head Neck Surg. 1996; 122: 122-129
- Embolization for intractable epistaxis.Tech Vasc Interv Radiol. 2005; 8: 134-138
- Quality improvement guidelines for adult diagnostic neuroangiography.Am J Neuroradiol. 2000; 21: 146-150
- Endovascular treatment of a pseudoaneurysm of the descending palatine artery after orthognathic surgery: technical note.Int J Oral Maxillofac Surg. 2005; 34: 321-323
- The transpalatal approach for juvenile nasopharyngeal angiofibroma.Operat Tech Otolaryngol Head Neck Surg. 1999; 10: 98-100
- Management of juvenile angiofibroma via midfacial degloving with medial maxillectomy.Operat Tech Otolaryngol Head Neck Surg. 1999; 10: 107-108
- Secondary deformities of the cleft lip, nose, and palate.in: Mathes S.J. Hentz V.R. 2nd edn. Plastic surgery. vol 4. Saunders; Elsevier, Philadelphia2006: 339-363
- A comparison of the donor-site morbidity after using the prelaminated fasciomucosal flap and the fasciocutaneous radial forearm flap for intraoral reconstruction.Br J Plast Surg. 2002; 55: 198-202
- Comparison of the radial forearm flap and the thinned anterolateral thigh cutaneous flap for reconstruction of tongue defects: an evaluation of donor-site morbidity.Plast Reconstr Surg. 2004; 114: 1704-1710
- Use of radial forearm free flaps in oncologic surgery of the head and neck.Operat Tech Otolaryngol Head Neck Surg. 2000; 11: 184-192
Article info
Publication history
Published online: January 22, 2007
Accepted:
October 31,
2006
Received:
February 25,
2006
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.