- 期刊
Surgical Treatment of Nasopharyngeal Angiofibroma
鼻咽血管纖維瘤之手術治療
摘要
背景 鼻咽血管纖維瘤為一良性腫瘤，但具有局部侵犯及容易復發之特性，本報告探討其臨床表現及治療方式，並就相關文獻加以討論。 方法 自1984年9月至2001年9月，共有13名鼻咽血管纖維瘤患者在本院接受追蹤及治療，就其年齡、性別、臨床症狀、治療方式、併發症及治療結果加以分析。 結果 十三名鼻咽血管纖維瘤患者平均年齡為18.5歲，且皆為男性。最常之表現為鼻部出血、鼻塞、鼻腔分泌物及痰中帶血。13名患者皆於術前接受電腦斷層，11位接受血管攝影及術前血管栓塞，但只有10位患者栓塞成功，之後11位接受開放式手術，2位接受鼻內視鏡手術，術後併發症則有1例黏液囊腫，1例口咽瘻管，分別接受黏液囊腫切除及口咽瘻管修補後恢復情形良好。 結論 鼻咽血管纖維瘤在術前血管栓塞之後，依腫瘤的大小，選擇以面中骨肉剝離術或鼻內視鏡手術處理鼻咽血管纖維瘤皆可有良好的治療效果。
並列摘要
Background. Nasopharyngeal angiofibroma is a histologically benign, but locally invasive tumor with a high incidence rate of persistence and recurrence. This study was performed to assess the clinical manifestation and various approaches of treatment and complications encountered during follow-up. Methods. Nasopharyngeal angiofibroma was diagnosed in 13 patients at our department between September 1984 and October 2001. We retrospectively evaluated the epidemiology, symptoms, tumor staging and treatments. Results. All of the patients were males. The mean age at diagnosis was 18.5 years. The most common symptoms were epistaxis, nasal obstruction, nasal discharge and blood-tinged sputum. The locations of tumors were commonly at the nasopharynx and nasal cavities. Preoperative angiographic embolization was performed on all patients, which significantly reduced intraoperative blood loss. Open surgery was performed on 11 patients and 2 patients underwent transnasal endoscopic surgery. None of the patients received radiotherapy. Conclusions. Surgical intervention with preoperative angiographic embolization should remain the treatment of choice. The endoscopic removal of nasopharyngeal angiofibroma is appropriate for small tumors, but open approaches should be considered for extensive lesions.