Juvenile nasopharyngeal fibroma

At the Juvenile nasopharyngeal fibroma it is a tumor of a benign to malignant nature. The juvenile nasopharyngeal fibroma develops in the area of ​​the roof of the throat. In the majority of cases, boys are affected by juvenile nasopharyngeal fibroids after the age of ten. The juvenile nasopharyngeal fibroma is one of the angiofibromas and thus represents a fibroma with numerous vessels.

What is juvenile nasopharynx?

The Juvenile nasopharyngeal fibroma is also among the synonymous names Basal fibroid and Juvenile angiofibroma known. From a histological point of view, the juvenile nasopharyngeal fibroma is a benign tumor. Due to its aggressive growth behavior, however, juvenile nasopharyngeal fibroma is one of the malignant tumors from a clinical perspective.

This is because juvenile nasopharyngeal fibroma displaces and destroys structures in the paranasal sinuses, the nose, the orbit and the pterygopalatine fossa as it grows. Basically, the juvenile nasopharyngeal fibroma is located on the roof of the pharynx or in the lateral area of ​​the nasopharynx. Juvenile nasopharyngeal fibroma occurs more frequently in males in childhood. The malignant tumor is particularly evident in boys who are older than ten years.

causes

The causes and processes of the pathogenesis of juvenile nasopharyngeal fibroma have not yet been researched in detail. On the one hand, genetic factors can be considered for the development of juvenile nasopharyngeal fibroma. On the other hand, juvenile nasopharyngeal fibroma may arise from external influences on the affected people. It is also not yet known exactly why juvenile nasopharyngeal fibroma occurs more frequently in male patients of a certain age group.

Symptoms, ailments & signs

The juvenile nasopharyngeal fibroma is principally a benign tumor as it does not form any metastases. However, its growth behavior destroys other structures in the area of ​​the nose and throat, so that from a clinical point of view, juvenile nasopharyngeal fibroma is usually one of the malignant tumors. The juvenile nasopharyngeal fibroma has numerous vessels and is formed from the connective tissue.

Usually the juvenile nasopharyngeal fibroma arises from the fibrocartilago basilaris and the arteria sphenopalatina. The tumor is specifically located on the roof of the throat or the lateral area of ​​the nasopharynx. The juvenile nasopharynx spreads mainly locally and shows a relatively aggressive growth behavior.

Here, the juvenile nasopharyngeal fibroma displaces other structures in the area and spreads increasingly towards the base of the skull, nose and paranasal sinuses, cavernous sinus and pterygopalatine fossa. Juvenile nasopharyngeal fibroma causes numerous symptoms of varying severity in mostly child patients. For example, juvenile nasopharyngeal fibroma initially affects breathing through the nose.

In addition, the juvenile nasopharyngeal fibroma causes purulent rhinitis and rhinophonia clausea. In most cases, juvenile nasopharyngeal fibroma also interferes with the function of the tubes. Sometimes the patients suffer from conductive hearing loss due to juvenile nasopharyngeal fibroma. Other classic symptoms of the tumor are headaches and frequent nosebleeds.

If the base of the skull is infiltrated, the first six nerves of the brain may fail. If the juvenile nasopharynx spreads unhindered, a bulge sometimes develops in the area of ​​the facial skull. With juvenile nasopharyngeal fibroma, there is a fundamental risk that the patient will bleed to death. The vessels of the tumor rupture quickly, causing nosebleeds and internal bleeding.

Diagnosis & course of disease

The diagnosis of juvenile nasopharynx is made, for example, by an ENT doctor. During the initial anamnesis, the specialist discusses the symptoms, the onset of the first complaints and possible influencing factors that contributed to the development of juvenile nasopharyngeal fibroma together with the patient and, if necessary, with the legal guardian.

A posterior rhinoscopy is used for the clinical examination. The juvenile nasopharyngeal fibroma appears as a bulbous tumor with a gray-red color and a smooth surface structure. In addition, the numerous vessels on the surface of the juvenile nasopharyngeal fibroma as well as the formation of runnings in the nasopharynx and the choans are visible.

In addition, the specialist uses imaging methods such as an MRI scan to precisely determine the location and extent of the juvenile nasopharyngeal fibroma. A biopsy is usually not done, as this increases the risk of bleeding from injuries to the juvenile nasopharynx. Sometimes the doctor will use angiography to get more information about juvenile nasopharyngeal fibroma.

In the differential diagnosis of juvenile nasopharyngeal fibroma, possible hyperplasia of the pharyngeal tonsil must be excluded. A choanal polyp and a nasopharyngeal cyst should also be considered.

Complications

The nasopharynx can cause various complaints. These strongly depend on the spread of the tumor. In most cases, however, this results in damage to the nose and throat. Most patients suffer from impaired breathing.

This can also lead to shortness of breath, which is associated with a panic attack. The breathing difficulties also often lead to fatigue or fatigue. Furthermore, hearing loss can develop, which can make the patient's everyday life significantly more difficult.

Those affected often also suffer from nosebleeds and severe headaches. These can lead to restrictions in concentration and coordination and thus have an overall negative effect on the patient's quality of life. Treatment of nasopharyngeal fibroma does not lead to further complaints or complications.

This can be removed by surgery or radiation therapy. The patient's life expectancy is usually not reduced after removal. The formation of new tumors is also relatively unlikely. However, the person affected is still dependent on regular examinations.

When should you go to the doctor?

Difficult breathing or disturbances in breathing are worrying. If there are no colds, a doctor should be consulted if the oxygen supply through the nose is impaired. Otherwise, the body will not be supplied with enough oxygen and can trigger further diseases. If there is a tightness in the throat or in the back of the nose, it is advisable to have a check-up. Consult a doctor if you experience impaired hearing or balance disorders. A doctor should be consulted if there is a feeling of pressure in the front area of ​​the head, headache or earache.

If the person concerned suffers from frequent and uncontrolled nosebleeds, discomfort of the jaw or teeth, a visit to the doctor is necessary to clarify the discomfort. If the symptoms persist for several weeks or months, a doctor must be consulted. If the complaints increase, immediate action is necessary. If a deformation of the face is perceived, the juvenile nasopharyngeal fibroma has already enlarged considerably. In these cases, a medical examination should be initiated as soon as possible, as serious complications can arise in the event of a malignant course of the disease. If there are sensory disorders, numbness or hypersensitivity to touch, a doctor's visit is advisable. If you have trouble sleeping, snoring or refused to eat, a doctor should be consulted.

Treatment & Therapy

In some patients, juvenile nasopharyngeal fibroma resolves spontaneously after the affected person has completed the pubertal phase. Because of the symptoms, however, the tumor is usually surgically removed. The doctor removes juvenile nasopharyngeal fibroids of smaller size through the nose using endoscopy.

Larger juvenile nasopharyngeal fibroids require a complicated surgical procedure involving transfacial extirpation and removal of the tumor through the oral vestibule. In some cases, surgical intervention is not possible, so radiation therapy is used to combat juvenile nasopharyngeal fibroids. The aim of this is to reduce the size of the juvenile nasopharyngeal fibroma. In general, juvenile nasopharyngeal fibroids often recur even after successful removal. However, the likelihood of this decreases with the end of the 25th year of life.

Outlook & forecast

The prognosis of juvenile nasopharyngeal fibroma depends largely on the benign or malignant nature of the tumor. Although it is a tumor disease that does not form metastases in the organism, serious disorders and sequelae are to be expected in the case of malignant growth. If left untreated, the tumor leads to premature death. The symptoms such as headache or bleeding from the nose increase and lead to a reduced quality of life. In addition, limitations in memory and concentration are to be expected. If medical treatment is sought, the possible therapy is determined depending on the size and location of the tumor.

Surgical removal of the diseased tissue can result in complications and risks. These worsen the prognosis. If an intervention is carried out without further disturbances, recovery occurs in most cases. The existing symptoms recede immediately after the tumor has been removed. Radiation therapy is used in some patients before surgery. Numerous side effects occur here, which lead to a further deterioration in quality of life. In the long term, however, radiation therapy offers the possibility of complete removal of the tumor. The need for radiation depends on the individual requirements, depending on the size of the tumor and its further growth characteristics.

prevention

Juvenile nasopharyngeal fibroma cannot yet be effectively prevented, because the causes of the tumor development are still largely unclear.

Aftercare

In most cases of this disease, there are no direct follow-up measures available to those affected. First and foremost, a doctor must be consulted quickly and, above all, at an early stage so that no further complications occur and the tumor does not continue to spread. The earlier a doctor is consulted, the better the further course of the disease usually is, so that the person affected should see a doctor at the first symptoms and signs.

The treatment itself takes the form of a surgical procedure. After this procedure, the person affected should rest and rest. Exertion or physical and stressful activities should be avoided in order not to unnecessarily burden the body. The oral cavity should also be particularly well protected so that there are no infections or inflammations.

Even after the tumor has been successfully removed, regular checks and examinations by a doctor are necessary so that further tumors can be detected and removed at an early stage. The life expectancy of the person affected may be reduced by this disease if the tumor is detected late. However, a general prediction about the further course of the disease cannot be made.

You can do that yourself

First of all, it is very important for patients with juvenile nasopharynx that a doctor diagnoses the disease quickly. A timely detection of the juvenile nasopharyngeal fibroma increases the probability that the disease can be successfully treated and thus also increases the survival rate of the affected person. In order to actively contribute to the success of the therapy, the patients appear for all necessary examination appointments and always follow the instructions of the doctors, especially before and after surgical interventions.

In numerous cases, doctors remove the juvenile nasopharyngeal fibroma during a surgical procedure, which varies depending on the size of the fibroma. This operation is often associated with an inpatient stay in the hospital for the patient. Those affected adhere to the regulations of the nursing staff, such as bed rest and taking medication on time.

In severe cases, operations are not possible, so radiation therapy is necessary. The patients work harder to strengthen their physical defenses and avoid infections. In general, with juvenile nasopharyngeal fibroma, it is important that the patient undergoes regular medical follow-up examinations even after successful surgical removal of the fibroma in order to quickly identify any recurrences. This means that subsequent fibromas can be removed at an early stage.