Se discuten los resultados y se presentan conclusiones. A meta-analysis of the different kinds of treatment used is reported; according to the english literature in the last 20 years. The results are discussed, and our conclusions presented. Key words: Juvenile nasopharyngeal angiofibroma, meta-analysis. Debido a esto, la nasofaringe es el sitio que se afecta de manera primaria. Entre los que se usan con mayor frecuencia podemos contar: Chandler, Sessions, Fisch, de Santos y Andrews, entre otras.
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They account for only 0. Clinical presentation The presentation is typical with obstructive symptoms, epistaxis , and chronic otomastoiditis due to obstruction of the Eustachian tube. Patients may present with life-threatening epistaxis.
On examination, it may be seen as a pale reddish-blue mass. It is, as the name suggests, very vascular and a biopsy can sometimes be fatal. Pathology Juvenile nasopharyngeal angiofibromas are benign but highly vascular tumors. They may be locally aggressive.
The exact site of origin is contentious as these masses usually present when they have reached a considerable size. However, most authors agree that they arise from the posterior choanal tissues in the region of the sphenopalatine foramen.
Staging See staging of juvenile nasopharyngeal angiofibromas. Radiographic features Imaging plays an important role in diagnosis due to its vascular nature, as biopsies should be avoided due to the risk of brisk hemorrhage, as well as staging.
Although these masses are thought to arise from the region of the sphenopalatine foramen , they are usually sizeable at diagnosis, frequently with extension medially into the nasopharynx , laterally into the pterygopalatine fossa and, over time, beyond into the orbit , paranasal sinuses , intracranial cavity and infratemporal fossa. Plain radiograph Plain radiographs no longer play a role in the workup of a suspected juvenile nasopharyngeal angiofibroma, however, they may still be obtained in some instances during the assessment of nasal obstruction, or symptoms of sinus obstructions.
Findings are similar to those described above. Typically a lobulated non-encapsulated soft tissue mass is demonstrated centered on the sphenopalatine foramen which is often widened and usually bowing the posterior wall of the maxillary antrum anteriorly. There is marked contrast enhancement following administration of contrast, reflecting the prominent vascularity.
Extensive bony destruction is usually not a feature, but rather bone is remodelled or resorbed. This feature may be helpful in differentiating from other more aggressive lesions.
An intracranial extension can however occur. Angiography DSA Angiography, although not essential, is often useful in both defining the feeding vessels as well as in preoperative embolization. Supply of these tumors is usually via
Angiofibroma nasofaríngeo juvenil
Angiofibroma juvenil nasofaríngeo. Metaanálisis