| Objective: To investigate the feasibility,safety,clinical efficacy and prognosis of nasopharyngeal hemangioma resection under nasal endoscopy by analyzing the clinical data of patients with nasopharyngeal angiofibroma.Methods: A retrospective study was conducted in 20 patients with nasopharyngeal angiofibroma diagnosed by nasopharyngeal and head and neck surgery from October 2012 to May 2017,who underwent endoscopic resection of JNA in the First Affiliated Hospital of Xinjiang Medical University.the patient's Clinical data included the patient's medical records,imaging data,intraoperative bleeding and postoperative pathology.The patients were followed up for at least 9 months.According to the follow-up results,the recovery and recurrence of JNA patients were observed.Following the Radowski staging system to schedule JNA.The number of hospital days and the time of operation were statistically analyzed by independent sample t test.Result: The 20 cases are all male,aged 12 to 40 years,mean age is 18.8 years old.Including Han nationality 6 cases,Hui 1 case,Uygur11 cases,1 case of Mongolian,Kazak 1 case.Patients with nasal congestion,accompanied by thick nose,oral breathing,who are persistent or intermittent epistaxis.Check visible nasopharynx,nasal cavity with pink mass,smooth surface.20 cases of postoperative specimens were submitted to the pathological test.the results confirmed that the tumor is JNA.According to preoperative endoscopy,radiographic examination(CT/MRI)and Radowski stage,JNA patients were graded: Ia in 7 cases,Ib in 4 cases,IIa in 1 case,IIb in 2 cases,IIc in 1 case,IIIa in 5 cases.All patients with JNA excision in the nasal endoscopy,the average intraoperative blood loss:?a period of about 142 ml,?b period of about 225 ml,? a period of about 100 ml,? b period of about 600 ml,?c period of about 300 ml,? a period of about 1100 ml.Postoperative follow-up found that 2 cases of recurrence,the total recurrence rate of 10%.There were 1 case recurrence(recurrencerate 9.1%)in stage ?,0 case recurrence(recurrence rate 0.0%)in stage II and recurrence rate(20% recurrence rate)in stage ?.Compared with stage ? and stage ?,the recurrence rate of JNA was higher.DSA cases,13 cases of all cases of external carotid artery branch blood supply,of which 61.5% of the unilateral jaw internal artery blood supply,30.8% of bilateral jaw internal artery blood supply,7.7% bilateral bilateral jaw internal artery combined with traffic support blood,Indicating that JNA tumor blood supply mainly to unilateral jaw internal artery,bilateral jaw internal artery combined with traffic support blood rare.The effect of different tumor staging on postoperative hospital stay showed that compared with stage I,the number of hospital stay was significantly increased in stage ?,the difference was statistically significant.But the other sub-period differences were not statistically significant.Conclusion: JNA mainly occurs in male adolescents,all ethnic groups have onset,the incidence of the existence of ethnic distribution characteristics to be further studied.JNA tumor blood mainly to unilateral jaw internal artery,bilateral jaw internal arteries with traffic congestion rare.The effect of preoperative embolization and non-embolization on the estimated mean blood loss during surgery showed that the embolization group was less than that of the non-bolting group.Endoscopic surgery than conventional surgery complications less cases,the recurrence rate is low,can significantly reduce the amount of intraoperative blood loss,shorten the operation time,for the ? cases can be completely removed,clinical application of a wide range of prospects. |
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