Juvenile nasopharyngeal fibroma

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Classification according to ICD-10
D10 Benign neoplasm of the mouth and pharynx
D10.6 Nasopharynx
ICD-10 online (WHO version 2019)

The juvenile nasopharyngeal fibroma is a histologically benign tumor that originates from the roof of the pharynx. It usually occurs in male adolescents from the age of 10. Histologically, it is an angiofibroma , i.e. a vascularized fibroma . It grows locally, displacing and destroying the paranasal sinuses , the orbit , the pterygopalatine fossa and the nose. For this reason, its growth behavior is to be regarded as malignant.

Symptoms

Nasal breathing is impeded. It can also lead to purulent rhinitis , tube dysfunction and thus conductive hearing loss. Patients can also complain of headaches, and the tumor is well supplied with blood , leading to nosebleeds as the thin-walled vessels can tear quickly.

Complications

Cranial nerves I – VI may fail if the juvenile nasopharynx fibroma is infiltrated into the skull base .

diagnosis

The diagnosis is made by posterior rhinoscopy . A bulbous, palpable, hard, gray-red tumor with a smooth surface in the nasopharynx with extensions into the choans and vascular markings on the surface is evident . Imaging methods such as magnetic resonance tomography and, if bone destruction is suspected, computer tomography are also used. An angiography with embolization of the tumor can be done to lower the risk of bleeding. Because of the high risk of bleeding from the tumor, a biopsy of the tumor is not taken.

Therapy and prognosis

If the findings are large, surgery is indicated. Above, if possible, an embolization of the tumor are performed to reduce the risk of bleeding. Radiation should only be carried out in the case of inoperable tumors. The juvenile nasopharyngeal fibroma can resolve spontaneously after puberty.

literature

  • P. Nagel: Basics ear, nose and throat medicine. Urban & Fischer, Elsevier 2005, ISBN 3-437-42176-X , p. 80.
  • A. Franzen: Otorhinolaryngology: Short textbook for the GK 3. Urban & Fischer, Elsevier 2001, ISBN 3-437-42960-4 , p. 16.
  • Lenarz, Boenninghaus: ENT . 14th edition. Springer, 2012, ISBN 978-3-642-21130-0 , p. 256.