Juvenile Nasopharyngeal Fibroma

According to acronymmonster.com, Juvenile nasopharyngeal fibroma is a tumor ranging from benign to malignant. Juvenile nasopharyngeal fibroma develops in the roof of the throat. In the majority of cases, boys after the age of ten are affected by juvenile nasopharyngeal fibroma. Juvenile nasopharyngeal fibroma is one of the angiofibromas and is therefore a fibroma with numerous vessels.

Juvenile Nasopharyngeal Fibroma

What is juvenile nasopharyngeal fibroma?

Sometimes the patients suffer from conductive hearing loss due to the juvenile nasopharyngeal fibroma. Other classic symptoms of the tumor are headaches and frequent nosebleeds.

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

Because the 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 throat or in the lateral area of ​​the nasopharynx. Juvenile nasopharyngeal fibroma occurs more frequently in childhood males. The malignant tumor is particularly evident in boys over the age of ten.

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 come into consideration for the development of juvenile nasopharyngeal fibroma. On the other hand, the juvenile nasopharyngeal fibroma may be caused by external influences on the people affected. It is also not exactly known why juvenile nasopharyngeal fibroma occurs more frequently in male patients of a certain age group.

Symptoms, Ailments & Signs

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

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

The juvenile nasopharyngeal fibroma displaces other structures in the area and increasingly spreads towards the base of the skull, nose and paranasal sinuses, cavernous sinus and pterygopalatine fossa. Juvenile nasopharyngeal fibroma causes numerous symptoms of varying degrees of severity in the patients, most of whom are children. Juvenile nasopharyngeal fibroma initially affects breathing through the nose.

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

If there is an infiltration of the base of the skull, the first six nerves of the brain may fail. If the juvenile nasopharyngeal fibroma spreads unhindered, a bulge sometimes develops in the area of ​​the facial skull. In the case of juvenile nasopharyngeal fibroma, there is always a risk that the patient will bleed to death. The vessels of the tumor tear quickly, leading to nosebleeds and internal bleeding.

Diagnosis & course of disease

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

Posterior rhinoscopy is used for clinical examination. The juvenile nasopharyngeal fibroma appears as a bulbous tumor with a grey-red color and a smooth surface structure. In addition, the numerous vessels on the surface of the juvenile nasopharyngeal fibroma as well as the extensions into the nasopharynx and the choanae 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 performed, as this increases the risk of bleeding from injuries to the juvenile nasopharyngeal fibroma. Sometimes doctors do angiography to get more information about juvenile nasopharyngeal fibroma.

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

Complications

Nasal pharyngeal fibroma can cause various symptoms. These depend heavily 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. Difficulty breathing often leads to tiredness or exhaustion. Furthermore, hearing loss can develop, which can make everyday life of the patient significantly more difficult.

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

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

When should you go to the doctor?

Difficult breathing or disruptive influences on breathing activity are alarming. 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 feeling of tightness in the throat or in the back of the nose, it is advisable to have a check-up carried out. If hearing impairments or balance disorders occur, a doctor should be consulted. A doctor should be consulted if there is a feeling of pressure in the front part of the head, a headache or an earache.

If the person concerned suffers from frequent and uncontrolled nosebleeds, complaints of the jaw or teeth, a doctor’s visit is necessary to clarify the complaints. If the symptoms persist for several weeks or months, you should see a doctor. If the complaints increase, immediate action is required. If a deformation of the face is noticed, the juvenile nasopharyngeal fibroma has already greatly enlarged. In these cases, a medical examination should be initiated as soon as possible, as serious complications can occur if the disease progresses malignantly. If you experience sensory disturbances, numbness or hypersensitivity to touch, it is advisable to consult a doctor. in case of insomnia,

Treatment & Therapy

In some patients, the juvenile nasopharyngeal fibroma regresses spontaneously after the affected person has completed the pubertal phase. Because of the symptoms, however, surgical removal of the tumor is usually used. The doctor removes juvenile nasopharyngeal fibroids of smaller dimensions 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 fibroma. This pursues the goal of reducing the size of the juvenile nasopharyngeal fibroma. In general, juvenile nasopharyngeal fibroids often recur even after successful removal. However, the probability of this decreases at the end of the 25th year of life.

Outlook & Forecast

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

Surgical removal of the diseased tissue can involve complications and risks. These worsen the prognosis. If the procedure is performed without further disturbances, recovery occurs in most cases. The existing symptoms regress immediately after the tumor is removed. Radiation therapy is used in some patients before surgery. There are numerous side effects that lead to a further deterioration in the quality of life. In the long term, however, radiation therapy offers the possibility of completely removing the tumor. The need for radiation is determined according to individual requirements, depending on the size of the tumor and its further growth characteristics.

Prevention

The juvenile nasopharyngeal fibroma cannot be effectively prevented so far, because the causes of the tumor development are still largely unclear.

Aftercare

In most cases of this disease, there are no direct aftercare 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 so that the tumor does not continue to spread. The earlier a doctor is consulted, the better the further course of the disease, so that the person concerned should consult a doctor as soon as the first symptoms and signs appear.

The treatment itself is carried out by means of a surgical procedure. After this procedure, the patient should take it easy and rest. Efforts 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 infections or inflammation do not occur.

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 those 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 of great importance for patients with juvenile nasopharyngeal fibroma that a doctor diagnoses the disease quickly. Because a timely detection of juvenile nasopharyngeal fibroma increases the probability that the disease can be successfully treated and thus also increases the survival rate of those affected. In order to actively contribute to the success of the therapy, the patients appear at all necessary examination appointments and follow the instructions of the doctors, especially before and after surgical interventions.

In numerous cases, doctors remove the juvenile nasopharyngeal fibroma in 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 instructions of the nursing staff, such as bed rest and taking their medication on time.

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