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Otolaryngology: Otolaryngology. Treatment abroad

Juvenile nasopharyngeal angiofibroma (JNA) is a benign tumor of the nasopharynx, which is characteristic mainly for boys and young men. Structurally, it is composed of the fibrous tissue and thin-walled vessels, which are bleeding from time to time. The tumor is characterized by an aggressive course. Depending on the growth direction, over time it grows into the nasal cavity, paranasal sinuses and skull base, creating a threat to the patient’s life. The major treatment option is surgery. In some cases, the radiation techniques may be used.
Surgery

The choice of the surgical technique depends on the formation size:

  1. For small tumors, surgery can be performed endoscopically through the natural orifices (mouth or nose). Such an intervention can minimize the tissue trauma.
  2. Another option of removing small JNA is through the palate. The surgeon makes a horseshoe-shaped incision on the upper edge of the gums, excises a portion of the palate on the affected side, and then resects the tumor. Such an access provides a broad overview of the nasopharynx.
  3. Medial tumors, which invaded the nasal cavity or orbit, are removed through the maxillary sinus. The incision in this case is made under the upper lip.
  4. Large JNA, invading the base of the skull, are dissected through the infratemporal fossa.

The day before surgery, the angiography is performed, which allows the embolization (occlusion) of blood vessels feeding the tumor and reduces the risk of bleeding.

JNA is removed to the fullest extent possible. If the total resection is not possible, the formation is excised partially, and the patient is prescribed radiation therapy after surgery. The following techniques are well-proven for angiofibromas:

  1. Stereotactic surgery (Gamma Knife). The tumor residue is affected by a high dose of radiation, which leads to the tumor cell death. The flows of radiation particles are formed so that most of the energy was targeted at the pathological focus. Thus, the healthy tissue is almost not subjected to irradiation. The procedure is performed only once. The effect is manifested over the next 6 to 24 months.
  2. Conformal radiotherapy. The tumor is irradiated precisely from different angles. Consequently, the major impact is targeted exactly at the pathological focus. The surrounding tissues are damaged to a lesser extent than upon conventional irradiation techniques. The sessions are repeated daily for several weeks.

For inoperable JNA, the radiation techniques may be indicated as the main treatment option.

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University Hospital Cologne

9.8/10 from 82 Votes

Department of Otolaryngology

The Department of Otolaryngology provides both diagnosis and treatment of all types of diseases in the field of otolaryngology, for example, head and neck surgery, plastic surgery, vocal cord and voice disorders, incl. speech therapy and allergology.


location_onCountry: Germany
location_searchingCity: Cologne

University Hospital Bonn

9.2/10 from 150 Votes

Department of Oncology, Hematology, Rheumatology and Immunoncology

The key objective of the Department of Internal Medicine III is to create and offer optimal treatments for internal diseases on inpatient, partially inpatient and outpatient basis.


location_onCountry: Germany
location_searchingCity: Bonn
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University Hospital Frankfurt

9.5/10 from 97 Votes

Department of Hematology, Oncology, Rheumatology and Immunology

The Department of Hematology, Oncology, Hemostasis, Rheumatology and Infectology at the University Hospital Frankfurt specializes in the treatment of all diseases of the hymatopoietic system and solid tumors.


location_onCountry: Germany
location_searchingCity: Frankfurt am Main

Charite University Hospital Berlin

9/10 from 95 Votes

Charité Comprehensive Cancer Center

The Charite Comprehensive Cancer Center integrates all departments and units dealing with cancer treatment. The center offers patients the most advanced comprehensive cancer treatment.


location_onCountry: Germany
location_searchingCity: Berlin
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University Hospital Heidelberg

9/10 from 57 Votes

Department of Hematology, Oncology and Rheumatology

The Department of Hematology, Oncology and Rheumatology at the Heidelberg University Hospital makes every effort to provide medical care of the highest quality to the patients with oncologic and rheumatologic diseases.


location_onCountry: Germany
location_searchingCity: Heidelberg
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Academic Hospital Schwabing

8.5/10 from 7 Votes

Department of Hematology, Oncology, Immunology, Palliative Medicine, Infectiology and Tropical Medicine

The Department of Hematology, Oncology, Immunology, Palliative Medicine, Infectious Diseases and Tropical Medicine in Schwabing treats all benign blood diseases, disorders of the immune and coagulation system, all forms of blood cancer, and the most of cancers.


location_onCountry: Germany
location_searchingCity: Munich

Academic Hospital Nordwest

9.5/10 from 24 Votes

Department of Oncology and Hematology

The Department of Oncology and Hematology at the Hospital Nordwest is a medical institution, which deals with the diagnosis, treatment and follow-up care of patients with benign and malignant tumors of the hematopoietic system, as well as all kinds of cancer.


location_onCountry: Germany
location_searchingCity: Frankfurt am Main
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Hannover Medical School

9.8/10 from 43 Votes

Department of Otolaryngology

The Department of Otolaryngology at the Hannover Medical School has a special expertise in diagnosis and treatment of diseases in the area of ear, nose and throat medicine.


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location_searchingCity: Hannover
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Marienhaus Klinikum St. Elisabeth Neuwied

9.8/10 from 23 Votes

Department of Otolaryngology

The Department of Otolaryngology at the Marienhaus Klinikum St. Elisabeth Neuwied works in close cooperation with a private otolaryngology office of Dr. med. Joachim Hammer. There are performed all operations of minor and medium ENT surgery.


location_onCountry: Germany
location_searchingCity: Neuwied

District Hospital Waldbröl Oberberg

9.7/10 from 23 Votes

Department of Otolaryngology, Plastic Surgery, Facial Surgery

The Department of Otolaryngology at the District Hospital of Waldbröl provides conservative and surgical treatment of all diseases of ear (including hearing improvement), nose, paranasal sinuses, larynx and neck. The surgery is performed on the outpatient basis.


location_onCountry: Germany
location_searchingCity: Waldbrоl

Hospital Gummersbach Oberberg

9.6/10 from 23 Votes

Department of Otolaryngology, Facial Plastic Surgery, Head and Neck Cancer

The Department of Otolaryngology, Facial Plastic Surgery, Head and Neck Cancer offers medical care meeting the latest medical achievements and with the use of all diagnostic and surgical capabilities available this field.


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location_searchingCity: Gummersbach

University Hospital Düsseldorf

9.5/10 from 71 Votes

Department of Otolaryngology

The Department of Otolaryngology at the University Hospital Dusseldorf offers the full range of modern medical service in the field of otolaryngology and related disciplines. The Department offers You medical care of international standards with the latest diagnosis and treatment capabilities.


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location_searchingCity: Duesseldorf

University Hospital Giessen UKGM

9.5/10 from 35 Votes

Department of Otolaryngology, Head and Neck Surgery and Plastic Surgery

As a center of maximum medical care, the Department of Otolaryngology at the University Hospital Giessen covers the entire spectrum of otolaryngology at the highest possible level.


location_onCountry: Germany
location_searchingCity: Giessen

Academic Hospital Hildesheim

9.5/10 from 23 Votes

Department of Otolaryngology

The Department of Otolaryngology at the Academic Hospital Hildesheim performs not only head and neck surgery, but also treats neurosurgical diseases in this field. The department offers ENT treatment at the highest medical level. It also specializes in the implantation of auditory systems (active middle ear implants).


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location_searchingCity: Hildesheim

University Hospital Hamburg-Eppendorf

9.2/10 from 92 Votes

Department of Otolaryngology and Head-Neck Surgery

The Department of Otolaryngology, Head and Neck Surgery at the University Medical Center Hamburg-Eppendorf uses the latest technology to treat patients with any otolaryngological diseases.


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location_searchingCity: Hamburg
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University Hospital of the Ludwig-Maximilians-University Munich

9.2/10 from 40 Votes

Department of Otolaryngology

The Department of Otolaryngology offers outpatient and inpatient care. For this purpose, it has 102 beds and two large departments.


location_onCountry: Germany
location_searchingCity: Munich

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