Endoscopic embolization with onyx prior to resection of JNA: A new approach

Björn Herman, Michael Bublik, Jose Ruiz, Ramzi T Younis

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: To report a novel pioneering approach of endoscopic embolization (EE) and resection of juvenile nasopharyngeal angiofibroma (JNA) and describe all outcomes and results. Methods: Four patients presented to the University of Miami with repeated episodes of unilateral epistaxis diagnosed by fiberoptic and radiographic examination as nasal JNA. Subsequently, in conjunction with neurosurgery, endoscopic visualization was provided to perform intratumor needle insertion, through which the liquid embolic agent Onyx was infused to embolize the JNA's under fluoroscopic and endoscopic guidance. The day after EE, endoscopic resection was performed. Operating room time, estimated blood loss (EBL), and other intraoperative and post-operative results are reported and compared to published literature. Results: A total of 4 patients (all males), had EE of JNA and subsequent endoscopic resection between September 2008 and January 2009. Average EBL during surgery was 412.5. ml (range 150-800) with an average operating room time of 228. min (range 95-485). We experienced no bleeding from the tumor or its attachments, only from the approach. Two patients experienced mild numbness in the V2 distribution, which began to resolve one week post-operatively. No other complications were encountered. Conclusions: This is the first published report of direct endoscopic embolization of JNA with Onyx. Although further studies are needed, it seems to provide a safe, less invasive alternative to traditional embolization and endoscopic resection, but must be done in cooperation with interventional neurosurgery to maximize its safety profile.

Original languageEnglish
Pages (from-to)53-56
Number of pages4
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume75
Issue number1
DOIs
StatePublished - Jan 1 2011

Fingerprint

Angiofibroma
Neurosurgery
Operating Rooms
Epistaxis
Hypesthesia
Nose
Needles
Hemorrhage
Safety
Neoplasms

Keywords

  • Juvenile nasopharyngeal angiofibroma
  • Pediatric sinus surgery
  • Percutaneous embolization

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health

Cite this

Endoscopic embolization with onyx prior to resection of JNA : A new approach. / Herman, Björn; Bublik, Michael; Ruiz, Jose; Younis, Ramzi T.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 75, No. 1, 01.01.2011, p. 53-56.

Research output: Contribution to journalArticle

@article{b69a5490a521436ab7b06cf447b350c6,
title = "Endoscopic embolization with onyx prior to resection of JNA: A new approach",
abstract = "Objective: To report a novel pioneering approach of endoscopic embolization (EE) and resection of juvenile nasopharyngeal angiofibroma (JNA) and describe all outcomes and results. Methods: Four patients presented to the University of Miami with repeated episodes of unilateral epistaxis diagnosed by fiberoptic and radiographic examination as nasal JNA. Subsequently, in conjunction with neurosurgery, endoscopic visualization was provided to perform intratumor needle insertion, through which the liquid embolic agent Onyx was infused to embolize the JNA's under fluoroscopic and endoscopic guidance. The day after EE, endoscopic resection was performed. Operating room time, estimated blood loss (EBL), and other intraoperative and post-operative results are reported and compared to published literature. Results: A total of 4 patients (all males), had EE of JNA and subsequent endoscopic resection between September 2008 and January 2009. Average EBL during surgery was 412.5. ml (range 150-800) with an average operating room time of 228. min (range 95-485). We experienced no bleeding from the tumor or its attachments, only from the approach. Two patients experienced mild numbness in the V2 distribution, which began to resolve one week post-operatively. No other complications were encountered. Conclusions: This is the first published report of direct endoscopic embolization of JNA with Onyx. Although further studies are needed, it seems to provide a safe, less invasive alternative to traditional embolization and endoscopic resection, but must be done in cooperation with interventional neurosurgery to maximize its safety profile.",
keywords = "Juvenile nasopharyngeal angiofibroma, Pediatric sinus surgery, Percutaneous embolization",
author = "Bj{\"o}rn Herman and Michael Bublik and Jose Ruiz and Younis, {Ramzi T}",
year = "2011",
month = "1",
day = "1",
doi = "10.1016/j.ijporl.2010.10.006",
language = "English",
volume = "75",
pages = "53--56",
journal = "International Journal of Pediatric Otorhinolaryngology",
issn = "0165-5876",
publisher = "Elsevier Ireland Ltd",
number = "1",

}

TY - JOUR

T1 - Endoscopic embolization with onyx prior to resection of JNA

T2 - A new approach

AU - Herman, Björn

AU - Bublik, Michael

AU - Ruiz, Jose

AU - Younis, Ramzi T

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Objective: To report a novel pioneering approach of endoscopic embolization (EE) and resection of juvenile nasopharyngeal angiofibroma (JNA) and describe all outcomes and results. Methods: Four patients presented to the University of Miami with repeated episodes of unilateral epistaxis diagnosed by fiberoptic and radiographic examination as nasal JNA. Subsequently, in conjunction with neurosurgery, endoscopic visualization was provided to perform intratumor needle insertion, through which the liquid embolic agent Onyx was infused to embolize the JNA's under fluoroscopic and endoscopic guidance. The day after EE, endoscopic resection was performed. Operating room time, estimated blood loss (EBL), and other intraoperative and post-operative results are reported and compared to published literature. Results: A total of 4 patients (all males), had EE of JNA and subsequent endoscopic resection between September 2008 and January 2009. Average EBL during surgery was 412.5. ml (range 150-800) with an average operating room time of 228. min (range 95-485). We experienced no bleeding from the tumor or its attachments, only from the approach. Two patients experienced mild numbness in the V2 distribution, which began to resolve one week post-operatively. No other complications were encountered. Conclusions: This is the first published report of direct endoscopic embolization of JNA with Onyx. Although further studies are needed, it seems to provide a safe, less invasive alternative to traditional embolization and endoscopic resection, but must be done in cooperation with interventional neurosurgery to maximize its safety profile.

AB - Objective: To report a novel pioneering approach of endoscopic embolization (EE) and resection of juvenile nasopharyngeal angiofibroma (JNA) and describe all outcomes and results. Methods: Four patients presented to the University of Miami with repeated episodes of unilateral epistaxis diagnosed by fiberoptic and radiographic examination as nasal JNA. Subsequently, in conjunction with neurosurgery, endoscopic visualization was provided to perform intratumor needle insertion, through which the liquid embolic agent Onyx was infused to embolize the JNA's under fluoroscopic and endoscopic guidance. The day after EE, endoscopic resection was performed. Operating room time, estimated blood loss (EBL), and other intraoperative and post-operative results are reported and compared to published literature. Results: A total of 4 patients (all males), had EE of JNA and subsequent endoscopic resection between September 2008 and January 2009. Average EBL during surgery was 412.5. ml (range 150-800) with an average operating room time of 228. min (range 95-485). We experienced no bleeding from the tumor or its attachments, only from the approach. Two patients experienced mild numbness in the V2 distribution, which began to resolve one week post-operatively. No other complications were encountered. Conclusions: This is the first published report of direct endoscopic embolization of JNA with Onyx. Although further studies are needed, it seems to provide a safe, less invasive alternative to traditional embolization and endoscopic resection, but must be done in cooperation with interventional neurosurgery to maximize its safety profile.

KW - Juvenile nasopharyngeal angiofibroma

KW - Pediatric sinus surgery

KW - Percutaneous embolization

UR - http://www.scopus.com/inward/record.url?scp=78650979323&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650979323&partnerID=8YFLogxK

U2 - 10.1016/j.ijporl.2010.10.006

DO - 10.1016/j.ijporl.2010.10.006

M3 - Article

C2 - 21051094

AN - SCOPUS:78650979323

VL - 75

SP - 53

EP - 56

JO - International Journal of Pediatric Otorhinolaryngology

JF - International Journal of Pediatric Otorhinolaryngology

SN - 0165-5876

IS - 1

ER -