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RMJ. 2016; 41(1): 90-94

Endoscopic removal of juvenile nasopharyngeal angiofibroma: conventional versus coblation-assisted

Salina Husain, Izham Mesran, Syed Zaifullah, Balwant Singh Gendeh, Mohd Razif Yunos.

Objective: To review the outcomes of endoscopic removal of juvenile nasopharyngeal angiofibroma (JNA) with or without coblation.
Methodology: This is a retrospective study of 10 patients who underwent endoscopic removal of JNA from January 2004 to November 2014 at the Otorhinolaryngology-Head Neck Surgery, Universiti Kebangsaan Malaysia Medical Center.
Results: Five patients had Stage I, 3 patients with Stage II and another 2 patients with Stage IIIa tumors. All patients were males with age range of 10-32 years. Majority of patients were in their 2nddecade of life. All underwent endoscopic removal of the JNA within 24 hours post angiogram and embolization. Three patients were operated using coblator (Stage I, II and IIIa tumors) and 7 patients without coblation-assisted surgery (Stage I, II and IIIa). Endoscopic removal of tumor with coblation had a mean blood loss of 0.9 liter with no blood transfusion. The mean duration of hospital stay was 2 days. On the other hand, endoscopic removal of tumor without coblation-assisted had mean blood loss of 1.2 with mean blood transfusion of 1.2 pint. The mean hospital stay was 5.8 days.
Conclusion: Endoscopic approach in JNA resection is treatment of choice, as it provides less invasive nature, minimal morbidity and better visualization. In combination with coblation-assisted endoscopic JNA resection, this further decreased intraoperative hemorrhage and provided better resection of the tumor.

Key words: Angiofibroma, endoscopic, coblation

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