Endoscopic endonasal surgical techniques used to treat rare vascular tumors

December, 25/2020 - 09:22

Endoscopic endonasal surgical technique is the gold standard to treat juvenile nasopharyngeal angiofibroma, a rare benign vascular tumor that appears in the nasal cavity, doctors at HCM City Children’s Hospital 1 have said.

 

A doctor and nurse at HCM City Children’s Hospital 1 examine a 13-year-old patient from Tây Ninh Province with juvenile nasopharyngeal angiofibroma. — Photo courtesy of the hospital

HCM CITY — Endoscopic endonasal surgical technique is the gold standard to treat juvenile nasopharyngeal angiofibroma, a rare benign vascular tumour that appears in the nasal cavity, doctors at HCM City Children’s Hospital 1 have said.

“These techniques have become more widespread recently as there are advantages like reduced blood loss during surgery, fewer post-op complications, and reduced length of hospital stay compared to open surgery,” Dr Dương Minh Toàn of the hospital’s ear-nose-throat department, said.

Dr Nguyễn Tuấn Như, head of the department, said there is no tumuor recurrence.  

The techniques have been used to treat a 13-year-old from Tây Ninh Province. On November 22 the patient was brought to the hospital with excessive bleeding from the left nostril.

He had suffered from repeated nosebleeds for a year, with bleeding lasting more than 30 minutes.

Local doctors had diagnosed a nasal infection, but his situation became worse.

At the Children’s Hospital 1, doctors found a white mass in the left nostril of the boy, and said he had juvenile nasopharyngeal angiofibroma (JNA).

They used endoscopic endonasal surgical techniques to remove the 12-centimetre tumour on December 2. The process took five hours. 

The patient has recovered and was discharged from the hospital on December 18, Toàn said.

Dr Như said that JNA is uncommon, and is a benign vascular tumour, but it is dangerous because the tumour is in a position where it is very difficult for doctors to remove.

If the patient is not treated early, the blockage of the eustachian tube may cause deafness and otalgia. The patient also could suffer from headaches due to chronic sinusitis or intracranial extension, Như said.

Pressure on the optic chaisma may cause vision impairment, he added.  

According to Dr Toàn, the hospital admits 10-15 patients with JNA every year. JNA accounts for nearly 0.5 per cent of head and neck tumours. The cause of the disease is not known. It occurs almost exclusively in males. The average age of onset is 15 years old.  

Its symptoms include nasal obstruction, repeated nosebleeds and anaemia. The voice acquires a nasal intonation and may become plummy if swelling enlarges to force the soft palate down.

Parents should bring their children to hospitals for examination and treatment if a nosebleed lasts for more than 15 minutes. — VNS

 

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