Abstract
The objective of the study was to evaluate the classification, therapeutic procedures and therapeutic results in patients with angiofibroma of the nasopharynx. The study was retrospective, all results of preoperative imaging methods (CT and/or MR) were for the purpose of classification re-evaluated by one doctor.
In the trial patients were included where the minimal follow up period was 12 months. The group comprised 22 patients operated in 1989-1999.
Three patients of this group were operated on account of a relapse. The group comprised men aged 14-36 years, the mean being 22 years.
Radiological staging according to Chandler was used. The therapeutic results were evaluated on the basis of diagnostic imaging during the postoperative period.
In all patients CT was used and/or MR within the 7th postoperative day to rule out or confirm a residual tumour. A relapse of a tumour was diagnosed in patients without a postoperative residue where during the subsequent follow up a relapse of a tumour was proved by an imaging method.
The group did not comprise any patients with radiological classification I, five patients were classified as stage II, fourteen had classification III and three patients classification IV. In 18 patients preoperative embolization of the afferent vessels was made.
In all patients on surgery the approach was via medial maxillectomy by incision from lateral rhinotomy, in one patient this approach was combined with the orbitozygomatic approach. In 18 patients (82 %) the operation was radical, i.e. without a detectable residue after surgery.
Patients with a residue were carefully radiologically monitored, in one patient progression of the disease occurred and he was indicated for irradiation with Leksell's gammaknife. In three patients a relapse of the disease developed.
The relapses were treated by surgery, in one patient in combination with irradiation with Leksell's gammaknife. The residues and relapses were found in patients with tumours in the more advanced stages, i.e.
III and IV.