Stage III nasopharyngeal angiofibroma: Improving results with endoscopic-assisted midfacial degloving and modification to the Fisch staging system

ObjectivesTo study outcomes with endoscopic-assisted midfacial degloving for Fisch stage III nasopharyngeal angiofibroma and propose a new staging system.DesignRetrospective study of patients with Fisch stage III juvenile nasopharyngeal angiofibroma (JNA) including preoperative angiography, intraoperative blood loss and residue/recurrence following surgery.SettingTertiary care superspecialty referral center.ParticipantsFifteen consecutive patients with Fisch stage III JNA undergoing operations over a period of 18 months.Main outcome measuresPreoperative angiography details, intraoperative blood loss, residue/recurrence, complications of surgery.ConclusionsTransarterial embolization with particulate agents followed by endoscopic-assisted midfacial degloving provides excellent outcomes with Fisch stage III JNAs.The modified Fisch staging system proposed would allow better preoperative evaluation and comparison of outcomes with different treatment options for stage III JNAs.