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.

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

8.3/10 from 82 Votes

Department of Otolaryngology, Head and Neck Surgery

The Department of Otolaryngology, Head and Neck Surgery of the University Hospital Cologne in Germany provides the full range of diagnostic and therapeutic services in the field of otolaryngology, comprising head and neck surgery, plastic surgery, disorders of the vocal cords and voice, including lo...

location_onCountry: Germany
location_searchingCity: Cologne

Alfried Krupp Hospital in Essen-Ruettenscheid

9.9/10 from 42 Votes

Department of Otolaryngology, Head and Neck Surgery

The main focus of this department of the HNO Medicine, Throat, and Head Surgery at the Alfried Krupp Hospital in Essen is for micro-surgery of the tympanum, endonasal micro endoscopic surgery including surgery of the different lacrimal ducts, the diagnostic and operative therapy of sleep-related res...

location_onCountry: Germany
location_searchingCity: Essen

Hannover Medical School, MHH

9.8/10 from 43 Votes

Department of Otolaryngology

Hearing impairment is one of the most common diseases in our society. In Germany alone, about 15 million people of all ages suffer from various forms of this disease. All forms and degrees of hearing loss without exception can now be diagnosed and treated using the latest medical and technological developments.

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location_searchingCity: Hannover

Gummersbach District Hospital of the Klinikum Oberberg

9.6/10 from 23 Votes

Department of Otolaryngology and Facial Plastic Surgery

The Department of Otolaryngology and Facial Plastic Surgery offers the latest medical care involving all diagnostic and surgical capabilities of this field. The Department of supra-regional importance annually provides about 3,000 operations on both outpatient and inpatient basis.

location_onCountry: Germany
location_searchingCity: Gummersbach

University Hospital Dusseldorf

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.

location_onCountry: Germany
location_searchingCity: Duesseldorf

University Hospital Halle (Saale)

9.5/10 from 78 Votes

Department of Оtolaryngology, Head and Neck Surgery

Department of Оtolaryngology, Head and Neck Surgery at the University Hospital of Halle (Saale) offers a full range of services of the Оtolaryngology University Clinics. They include the most modern diagnostics, operational and conservative therapy of otolaryngology diseases, as well as phoniatrics and pedaudiology.

location_onCountry: Germany
location_searchingCity: Halle

UKGM Gießen

9.5/10 from 35 Votes

Department of Otolaryngology

The department of otolaryngology covers the entire spectrum of ear, nose and throat medicine of the highest level.

location_onCountry: Germany
location_searchingCity: Giessen

Hospital Hildesheim

9.5/10 from 23 Votes

Department of Otolaryngology

Apart from the surgery of the head and neck, otorhinolaryngology focuses on the non-surgical diseases in the area of ear, nose and throat. The clinic has access to the latest development of knowledge and serves as a competent medical partner.

location_onCountry: Germany
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.

location_onCountry: Germany
location_searchingCity: Hamburg

University Hospital Tubingen

9.2/10 from 55 Votes

Department of Otolaryngology

The Department of Otolaryngology at the University Hospital Tubingen has 64 beds in three stations and an intensive care unit. About 40,000 patients are treated on the inpatient basis every year.

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location_searchingCity: Tuebingen

Privat Hospital Leech

9.2/10 from 7 Votes

Department of Otolaryngology

All standard ENT operations are conducted in the Clinic of Leech. The principal objective and direction of the head and neck operations are the following surgical methods: endoscopic, endonasal operations in the sinus in case of chronic illnesses of the air cells (polypus), functional and esthe...

location_onCountry: Austria
location_searchingCity: Graz

DKD HELIOS Klinik Wiesbaden

9.2/10 from 5 Votes

Department of Otolaryngology

The practice of Otorhinolaryngology of the DKD HELIOS Klnik Wiesbaden has the modernist equipment, and offers comprehensive diagnostic, countseling and therapy in the field of diseases of the nose, throat and ear.

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location_searchingCity: Wiesbaden

Charite University Hospital Berlin

9/10 from 95 Votes

Department of Otolaryngology

The Department of Otolaryngology at the University Hospital Charité Berlin, located at the Virchow -Klinikum Clinicum, offers, through the interdisciplinary collaboration, individual options of treatment for all throat, nose and ear disorders according to the latest standards.

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location_searchingCity: Berlin

PAN Klinik

9/10 from 14 Votes

Department of Otolaryngology

The Department of Otolaryngology at the PAN Clinic offers the best medical care by an experienced team of doctors and excellent service.

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location_searchingCity: Cologne

University Hospital Heidelberg

9/10 from 57 Votes

Department of Otolaryngology

The patient is in the center of all efforts in the Department of Otolaryngology at the Heidelberg University Hospital. With respect to the clinical picture, there are provided specialized consultations as well as there are used innovative therapy forms and specialized surgical techniques.

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location_searchingCity: Heidelberg

University Hospital Erlangen

9/10 from 51 Votes

Department of Otolaryngology

Otolaryngology Clinic and Head and Neck Surgery Clinic at Erlangen University Clinic with 80 approved beds, 6 operating rooms, a leading ENT Intensive Care Unit with 5 beds and university outpatient clinic with 9 medical institutions it is one of the largest ENT clinics in Germany.

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location_searchingCity: Erlangen