The University Clinical Center Tuzla is offering a new surgical treatment of juvenile nasopharyngeal angiofibroma (JNA). Juvenile angiofibroma is a benign tumor that grows behind the nose, and occurs almost exclusively in adolescent boys. Although the tumor is not malignant, it affects the nasal mucosa and leads to nosebleeds. JNA can be big enough to keep air from passing through the nose, to press on parts of the nose, or invade surrounding structures, sinuses, eye or brain cavity. Imaging evaluation is primarily performed with either computed tomography (CT) or magnetic resonance imaging (MRI). Angiography can demonstrate feeding vessels that can extend to eye and brain cavity.
According to one of surgeons Hasan Altumbabić, MD, MSci., the first step in the treatment is transchateter embolization to shut down the blood supply to a tumor, which is then surgically removed. In case when the tumor has already spread to the brain cavity and cannot be surgically removed, radiotherapy is being applied. ” Our patient is a 14- year- old boy who had a car accident 6 months ago. He has not been breathing through his right nostril for 3 months and has frequent nasal bleeding. After additional neuroradiological assessment and CT angiography, juvenile angiofibroma that destroyed the inner wall of the eye cavity and partly the base of the brain with the endocranial propagation was suspected, and surgical treatment was indicated. ” said Dr. Altumbabić and explained that he surgery was done in two phases. In the first phase the embolization of blood vessels was done uneventful at the Clinic for Neurosurgery. In the second phase the tumor was surgically removed, and the resulting defect was reconstructed at the ENT Clinic. Dr. Altumbabić also said that the early postoperative recovery of the patient is going well.
The procedure of the embolization of blood vessels performed Ass. Prof. Mirza Moranjić and Dr. Adnan Čičkušić. The surgical team of the ENT Clinic consisted Dr. Hasan Altumbabić, Dr. Emir Šehanović, Dr Zlatka Džinić- Jusufović, dr. Samir Hodžić anesthesiologist, Indira Okanović anesthetician, and Alija Suljagić scrub technician.