Nersesyan M.V., Polev G.A., Muntean V.V., Popadyuk V.I. Blue laser in endoscopic endonasal removal of juvenile angiofibroma of the skull base. Head and neck. Russian Journal. 2023;11(1):14–20 The authors are responsible for the originality of the data presented and the possibility of publishing illustrative material – tables, drawings, photographs of patients.
Background. Juvenile nasal angiofibroma (JNA) is a very rare benign lesion originating from the pterygopalatine fossa with distinctive epidemiological features and a specific growth pattern. The typical patient is an adolescent male with a clinical history of recurrent severe nasal bleedings and congestion. Currently, surgery is considered the golden standard of JNA treatment, even though it often causes severe intraoperative bleeding. Improvements in preoperative embolization provide a significant reduction in intraoperative bleeding. Despite breakthroughs in endoscopic techniques that minimize the risk of relapse, the search for new devices that can help treat JNA is still ongoing to minimize surgical complications. Lasers have been used extensively as a surgical tool in rhinology over the past few decades. Indications for intranasal laser surgery are limited due to deep nasal mucosal burns and changes in mucociliary clearance, even though these interventions are virtually bloodless and often do not require nasal packing. Blue laser has recently become used in ENT surgery, and there are no data in the literature on its use for JNA removal.
Aim. The purpose of the study was to describe our experience of using new blue laser in JNA removal. Evaluation of advantages and disadvantages, determination of indications and limits of its use.
Material and methods. Endonasal endoscopic removal of JNA was performed in 7 patients. During the surgery, blue laser was used to cut the tissues and coagulate injured vessels.
Results. The average blood loss during surgery was 150 (50; 350) ml; there were no surgical complications. There were minimal reactive changes in the nose. All patients were discharged on the 2nd or 3rd day after the surgery. The special features of laser treatment included the possibility of coagulation and tissue dissection even in conditions of heavy bleeding and a minimal damage of the surrounding tissues with laser treatment.
Conclusion. The usage of the blue laser during endoscopic JNA removal showed good results with a minimal surgical trauma. The laser coagulates even in cases of severe nasal bleeding. Further studies should be conducted to understand the advantages and limits of using new blue laser in nasal surgery.
Key words: juvenile angiofibroma, nasopharyngeal tumor, skull base tumor, embolization, endoscopic nasal surgery, endoscopic removal of JNA, blue laser, laser surgery
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study