Treatment of Juvenile Nasopharyngeal Angiofibroma in Children

About the disease

Juvenile nasopharyngeal angiofibroma is a tumor which develops in the nasopharynx of male teenagers and adolescents. According to the MedScape, this tumor can bleed, that's why it is so dangerous.

Overall, juvenile nasopharyngeal angiofibroma is a rare tumor. It accounts for 0.05% of all head tumors. It can develop from the age of 7 till 19. It can develop only in males. Patients with juvenile nasopharyngeal angiofibroma have also been reported to have otolaryngological problems.

The exact cause of juvenile nasopharyngeal angiofibroma has not been identified yet. It has been suggested that hormonal disbalance can lead to development of juvenile nasopharyngeal angiofibroma. There are 2 proofs for that:  juvenile nasopharyngeal angiofibroma develops only in males and only during their prepuberty or puberty period. Further research is being conducted to determine which hormonal changes can lead to development of this rare tumor.

Juvenile nasopharyngeal angiofibroma most commonly constitutes nasal mass which develops in the nasopharynx. In rare cases, tumor can develop in the orbital area.

Patients with juvenile nasopharyngeal angiofibroma have been reported to suffer from serious otitis before were diagnosed with tumor. Some patients had blockage of eustachian tube as well. 

Symptoms

• Pain in the nasal area
• Inability to breathe freely through the nose
• Feeling of obstruction in the nasal cavity
• Headache
• Swelling of the nasal area

Diagnosis

• During a general examination, the doctor will examine the nasal cavity of a person and will palpate it to determine if there had been any strange hard masses.
• The doctor will also ask if a patient experienced any ear infections in the past.
• Hormonal test can determine if there is hormonal disbalance.
• Imaging tests, such as CT scan and MRI, can identify the tumor and determine its exact location along with the size.

Treatment

• Surgery treatment is a procedure used to remove the tumor and also remove nasal obstruction to ensure a patient breathes normally.
• Gamma Knife is a high-tech surgery used to remove the tumor without making an open incision.
• Radiation is a procedure used to shrink and irradiate the tumor as much as possible. It can be used before or after the surgery.
• Hormonal therapy is used if a patient has hormonal disbalance which needs to be fixed additionally to removing the tumor. 

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko