Experience in the surgical management of juvenile angiofibroma from 2016 to 2022 at a national pediatric reference center in Peru

• Autores: Oré Acevedo, Juan Francisco, Urteaga Quiroga, Rosmery, Florez Guerra, Walter, Matos Vasquez, Gustavo
• Formato: artículo
• Fecha de Publicación: 2025
• Institución: Instituto Nacional de Salud del Niño San Borja
• Repositorio: INSNS - Revistas
• Lenguaje: español
• OAI Identifier: oai:ojs.pkp.sfu.ca:article/143
• Enlace del recurso: https://investigacionpediatrica.insnsb.gob.pe/index.php/iicqp/article/view/143
• Nivel de acceso: acceso abierto
• Materia: Angiofibroma; Enndoscopía; Osteotomía Le Fort; Neoplasias Nasofaríngeas; Surgical Procedures, Operative; Endoscopic Surgical Procedures; Osteotomy, Le Fort

Introduction: Juvenile angiofibroma is a benign neoplasm with a prominent vascular component, most frequently presenting with nasal obstruction and epistaxis. Studies on this pathology are scarce, with most consisting of case reports or small case series describing a single surgical approach. Objectives: To describe the clinical characteristics, surgical management, and complications of juvenile angiofibroma in patients treated at the Instituto Nacional de Salud del Niño San Borja (Lima, Peru), from 2016 to 2022. Materials and Methods: Observational, descriptive study including patients with a histopathological diagnosis of juvenile angiofibroma who underwent surgical treatment during the study period. Sociodemographic, clinical, and surgical variables were collected. Tumor staging was performed using the Andrews-Fisch classification. Results: Seventy-four male patients with a mean age of 14 ± 1 years (range: 8–17 years) underwent surgical treatment. Sixty-six percent received a Le Fort I osteotomy, and 34 % underwent endoscopic surgery. Nasal obstruction was the predominant symptom in both groups, followed by epistaxis. Among tumors treated with Le Fort I osteotomy, 53 % were classified as stage IIIa, whereas 52 % of those treated endoscopically were classified as stage I. Two patients (4%) died due to surgical complications: one from cavernous sinus rupture during surgery, and the other from persistent status epilepticus on postoperative day four. Conclusions: The surgical management of juvenile angiofibroma should be guided by the tumor's extension. Endoscopic surgery is recommended for stages I and II, while open surgery is suggested for stages III and IV. Maintaining a high level of clinical suspicion in cases of epistaxis is crucial for providing timely management, preferably through endoscopic surgery in the early stages.