Angiofibroma Nasofaring Presentation

7/25/2019 Angiofibroma Nasofaring Presentation

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Angiofbroma

NasoaringPRESENTER :EMERALDY MODY (C 111 10 175

TR! "#RN!A$AN (C 111 11 %&%

PEM'!M'!N :

)r* AND! PANCA$AT!

'agian !+m, "-s-.a/an TT"L2a3,+/as "-)o3/-ran #ni4-rsi/as asan,))in&01


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PENDA#L#AN

Angiofbroma

NasoaringT,mor 6ina3 nasoaringangs-8ara .is/o+ogi3b-rsia/6ina39

s-8ara 3+inisb-rsia/ ganas

Ei)-mio+ogi!nsi)-n 1;50001;0*000 asi-n

TTr9 ,sia 71? /a.,n


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ANATOM! NASO2AR!N

S,-rior : basis s-noi) @ basis o88ii/a+An/-rior : "oanaPos/-rior : 2asia aringobasi+aris9 C 8-r4i8a+ 1)an &

!n-rior : Pa+a/,m mo++- )an is/.m,s aring


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!STOLO! NASO2AR!N

Norma+ Angiofbr


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AS"#LAR!SAS! NASO2AR!N

as3,+arisasi2aring : A* 8aro/is -B/-rnaA*

as8-n)-nS-/,m nasi : T-r+amir a)a


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ET!OLO!

E/io+ogi

!)ioa/i3

ormona+ S-B s/-roi) s/im,+a/ing .ormAn)rog-n (75=9 rog-s/-ron- (9%=9 -s/(0=P-ning3a/an T219 !2!! a)a s-+ /,mor

M,/asi )-+-si 3romosom 17 T,mor s,g-n- 5%9 ER&;n-,on8og-n-

M,/asi -n g+,/a/ionS/rans-ras- M1 (Ssi/oro/-3/or /-r.a)a an/io3si)an


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PATO2!S!OLO! Nasoaring(2ormam-ns.-noa+a/ina

An/-rior

Ca4,m nasi

D-4iasi s-/,m9)-s/r,3si 3on3a

La/-ra+

2oram-ns.-noa+a/ina

2ossa/-rgomaBi+a

2ossa!nra/-mora+

M-)ia+

Naso

M-n-bar 3- :

Sin,s M

2ossa

2ossam

Sin,s

Obs/r,3si Nasi

Eis/a3sis2rog 2a8-

Rasa P-n,. )i

a6a.C-.a+gia


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MAN!2ESTAS! "L!N!S

-6a+a Obs/r,3si nasi9 rinorr.-a

Eis/a3sis9 blood-stained rhinorrhea(r-8,rr-n/9 ,ni+a/-ra+

C-.a+gia

iosmia9 anosmia

O/a+gia9 r-8,rr-n/ o/i/is9 /,+i 3on),3/i

Di+oia

2a8ia+ S-++ing9 )-ormi/as ii9 rino+a+ia

Tan)a Rinos3oi os/-r

,/i. ab,ab, sab-r/ang3ai; /i)a3

Pa+a/,m '-ng3aii9 Pro/osis

O/i/is s-rosa9 /ris-mb-ng3a3an

P-n,r,nan -ngnerve tenting


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MAN!2ESTAS! "L!N!S

2rog a8- Massa in/ranasa+

Massa .i-ia -n

Trias Angiofbromas NasoaringMassa nasoaring;in/ranasa+

Obs/r,3si Nasi

Eis/a3sis '-r,+ang '-ng3Pa+a/


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PEMER!"SAAN PEN#NFAN

Labora/ori,m An-mia

Ra)io+ogi

2o/o Gra "-a+a CTS8an 3-a+a Po/ongan ABia+ Po/ongan Corona+

MR! Angiograf

is/oa/o+ogi

Ti)a3)i+a3,3ans-b-+,m /-ra(massi4-b+-))ing


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P-m-ri3saan Ra)io+og

Gra 3on4-nsiona+ CTS8an ABia+ (Tama3o+manMi++-r sign

CTS8a(Tama3 m

n


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P-m-ri3saan Ra)io+og

CT S8an 'on-$in)o

(Tama3 -+-baran

oram-n s.-noa+a/ina

CT S8an H "on/ras(Tama3 -+-baran

oram-n s.-noa+a/inaH P-n-baran 3- ossa

/-rgoa+a/ina

MR! Non"on/ras

MR! H "on/ras


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Angiograf

Angiograf )i+a3,3an ,n/,3 m-n8ari feedingartery

Pa)a gambar feeding artery = arterymaxillaris interna


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STAD!#M

Chandrel

Stadium I : Tumor di nasofaring.

Stadium II : Tumor meluas ke rongga

hidung dan atau sinus sfenoid.

Stadium III : Tumor meluas kedalam

antrum, sinus ethmoid, fossa

pterygomaksillaris, fossa infratemporalis.

Orbita dan atau pipi.

Stadium IV : Tumor meluas ke rongga

intrakranial.

Sessions

Stadium IA Tumor terbatas di nares posteri

nasofaring.

Stadium I Tumor meliputi nares posterior

nasofaring dengan keterlibatan sedikitnya sa

Stadium IIA Tumor sedikit meluas ke later

pterygomaxillary fossa.

Stadium II Tumor memenuhipterygomax

atau tanpa erosi superior dari tulang"tulang o

Stadium IIIA Tumor mengerosi dasar teng

cranial fossa/pterygoid base$% perluasan intr

Stadium III Tumor telah meluas ke intrak

tanpa perluasan ke sinus ka&ernosus.


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STAD!#M

2is8.s Stadium I Tumor terbatas di rongga hidung dan nasofaring

tanpa kerusakan tulang.

Stadium II Tumor mengin&asi fossa pterigomaksilaris,

sinus paranasal dengan kerusakan tulang.

Stadium III Tumor mengin&asi fossa infratemporal, orbitadan atau regio parasellar% sisanya di lateral sinus

ka&ernosus.

Stadium IV Tumors mengin&asi sinus ka&ernosus, regio

kiasma optik, dan atau fossa pituitari.


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D!ANOS!S

Anamn-sis

P-m-ri3saa

n 2isi3

P-m-ri3saan

-n,n6ang

Diagnosis 'an

1* Po+i nasa+9 o+i an/-ra/oma9 -n8-.a)-rmoi)s9 in4-r/ingr.ab)omosar8omas-+ s3,mo,s*

&* Eis/a3sis9 sis/-mi3%* ran,+oma iog-n

gran,+oma*I* Po+i 3oana+ (8.oan5* Po+i angioma/osa

(angioma/o,s o+* "is/a nasoaring-a+

(naso.arng-a+ 87* "arsinoma nasoar

Angiobroma

Nasofaring


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PENATALA"SANAANO-

ra/i

o+) S/an)ar)

Ra)io/-ra

i

#nr-s-8/ab+-

Li-T.r-a/-ning

T,mor

"-mo

/-rai

T,mor R-3,r-n H a)a riaa/

O-rasi )an Ra)io/-rais-b-+,mna

ormona+

M-ng,rangi ,3,ran/,mor )an

4as3,+arisasi

An/i An)rog-n An/iEs/rog-n

Pr- O-raEmbo


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Embo+isasi

Embo+isasi )i+a3,3an ,n/,3 m-n,mba/ feeding arterym-ng-r)ara.an 00=

Pa+ing s-ring Ar/-ri MaBi++aris !n/-rna

Ca4,m Nasi 8,3, m-n)aa/ -r)ara.an )ari a*8aro/is in/-rna )an

S-b-+,m S-/-


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O-rasi

T-rs-ri


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En)os8oi8 /ransnasa+

T,rbin-8/om

M-a/,

an/ro

Ligasi a* R-s-3si

/-r


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Transa+a/a+


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P-r/imbangan P-r-n8anaan O-ras

T,mor "-8i+ (!A9 !'9 !!A9 !!'9 !!C

En)os3oi Transnasa+Transa+a/a+

Transan/ra+ : Fi3a +-si m-n-bar 3- +a/-ra+ .ingga 3-ossa /-rgoa+a/ina

T,mor '-sar (!!!A9 !!!'R.ino/om La/-ra+

Midfacial Degloving

R-s-3si ra)i3a+ +,as


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"om+i3asi

P-r)ara.an /i)a3 /-r3on/ro+ S.o83 "-ma/ian "-sa)aran M-n,r,n -r+,asan 3- in/ra8rania+

O/i/is M-)ia -mo/iman,m

D-fsi/ n-,ro+ogis -rman-n

Iatrogenic In!ry

Transormasi Ma+igna


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Prognosis '-rgan/,ng a)a s/a)i,m saa/ /-r)iagnosis9 ma3in +,as ma3in

b,r,3 rognosis

R-3,r-nsi b-r3ai/an )-ngan

T,mor )i ossa /-rgoi)-,s )an basis s.-noi)

P-r+,asan in/ra8rania+

#sia m,)a

"eeding artery )ari ar/-ri 8aro/is in/-rna

A)ana sisa /,mor Embo+isasi m-n,r,n3an ang3a morbi)i/as )an 3-3amb,.an

R-s-3si rim-r )ari /,mor -B/ra8rania+ -n-mb,.an 100=

R-s-3si /,mor rim-r )i in/ra8rania+ ?0=


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Ta3- om- M-ssag-s

Angiofbroma Nasoaring T,mor s-8ara .is/o+ogis 6ina39 s-8ara3+inis ganas m-n)-s/r,3si 6aringan s-3i/ar

'-rasa+ )ari 6aringan i3a/ )an -mb,+,. )ara.

-6a+a 3.as obs/r,3si nasi9 massa nasoaring;in/ranasa+9-is/a3sis .-ba/ )an b-r,+ang

S-ring /-r6a)i a)a ana3 +a3i+a3i ,sia 71? /a.,n

P-nanganan go+) s/an)ar )-ngan o-rasi


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Da/ar P,s/a3a Ro-in A9 D.armaba3/i #S9 M,sa K* Angiofbroma Nasoaring '-+ia* Da+am: ',3, A6ar !+m, "-s-.a/an T-+inga9 i),ng9 T-nggoro39

"-a+a @ L-.-r* E)isi "--nam* E)i/or: So-ar)i EA9 )33* 2a3,+/as "-)o3/-ran #ni4-rsi/as !n)on-sia* Fa3ar/a* &007:11?0*

A)ams L* -org-9 'oi-s R* Lar-n8-9 ig.-r * P-/-r* 'O!ES ',3, A6ar P-na3i/ TT* E)i/or: E-n)i ar6an/o* E)isi * P-n-rbi/',3, "-)o3/-ran* Fa3ar/a: EC9 1??7* a+: %&I%&5

"irs8.n-r9 C* *9 N-//-r9 2* *9 @ Am-ri8an M-)i8a+ Asso8ia/ion* (&005* Netter#s atlas of h!man anatomy for $%& coding * C.i8ago9 !++*:

Am-ri8an M-)i8a+ Asso8ia/ion

Ni8o+ai P9 S8.r-ib-r A9 i++ar-/ A'* F,4-ni+- Angiofbroma: E4o+,/ion o Manag-m-n/* !n/-rna/iona+ Fo,rna+ o P-)ia/ri8s* ,b+is.-)on+in- No4 179 &011 8i/-) 6an,ari 1 &01Q* a4ai+ab+- rom: .//:;;*n8bi*n+m*ni.*go4;m8;ar/i8+-s;PMC%&&I00;

T-f3 TL MD* F,4-ni+- Naso.arng-a+ Angiofbroma9 on+in-Q9 (.//:;;-m-)i8in-*m-)s8a-*8om;ar/i8+-;7&50o4-r4i-s.oa++8i/-) on 6an,ari 1 &01Q

On)r- 29 $rig./ S"* N-o+asm o /.- Naso.arnB* !n:'-++-ng-rs Man,a+ o O/or.ino+arngo+og -a) an) N-83 s,rg-r*'$Decer* &00% I?&I?5*

Lim F9 -/ a+* Naso.arng-a+ Angiofbroma* -a) an) N-83 a/.o+og* !n :.//:;;*bron*-),;Co,rs-s;Digi/a+Pa/.;ss/-mi8a/.;.n;6na1*./m+ * 'ron M-)i8a+ S8.oo+* &005 (A3s-s Fan,ari &01

Par39 C.,+"-- -/*a+* R-8,rr-n/ F,4-ni+- Naso.arng-a+ Angiofbroma Tr-a/-) i/. amma "ni- S,rg-r* !n:

.//:;;63ms*org;,++/-B/;./m+;63ms&177%*./m+* )orean Academy of Medical *ciences+ A,g,s/ &1 &00

Mis.ra S9 Pra4--na N M9 Panigra.i R9 ,/a Y M* !maging in /.- )iagnosis o 6,4-ni+- naso.arng-a+ angiofbroma* F C+in !magingS8i &01%%9 S,+ S1:1

Ra.mani9 S.-r4in -/*a+* M-ningi/is An) Coma As T.- 2irs/ Mani-s/a/ion O F,4-ni+- Angiofbroma* !n:.//:;;*is,b*8om;6o,rna+;/.-in/-rn-/6o,rna+oo/or.ino+arngo+og;4o+,m-In,mb-r1%7;ar/i8+-;m-ningi/isan)8omaas.-frs/mani-s/a/iono6,4-ni+-angiofbroma*./m+* &he Internet ,o!rnal of Otolaryngology I**N./01-1203*

T-f3 TL* F,4-ni+- Naso.arng-a+ Angiofbroma* A4ai+ab+- #RL : .//:;;-m-)i8in-*m-)s8a-*8om;ar/i8+-;7&50or3,*

Li)ian- Maria )- 'ri/o Ma8-)o -/ a+* R-ss-8UVo -n)os8Wi8a )- nasoangiofbroma* R-4* 'ras* O/orrino+aringo+* on+in-Q* &009 4o+*7&9n*I9 * I75I0* !SSN 00%I7&??* .//:;;)B*)oi*org;10*15?0;S00%I7&??&00000I0000*

T-f3 TL* F,4-ni+- Naso.arng-a+ Angiofbroma* A4ai+ab+- #RL : .//:;;-m-)i8in-*m-)s8a-*8om;ar/i8+-;7&50/r-a/m-n/**
http://emedicine.medscape.com/article/872580-overview#showallhttp://jkms.org/fulltext/html/jkms-21-773.htmlhttp://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_4_number_1_37/article/meningitis_and_coma_as_the_first_manifestation_of_juvenile_angiofibroma.htmlhttp://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_4_number_1_37/article/meningitis_and_coma_as_the_first_manifestation_of_juvenile_angiofibroma.htmlhttp://emedicine.medscape.com/article/872580-workuphttp://emedicine.medscape.com/article/872580-workuphttp://dx.doi.org/10.1590/S0034-72992006000400008http://dx.doi.org/10.1590/S0034-72992006000400008http://emedicine.medscape.com/article/872580-workuphttp://emedicine.medscape.com/article/872580-workuphttp://dx.doi.org/10.1590/S0034-72992006000400008http://emedicine.medscape.com/article/872580-workuphttp://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_4_number_1_37/article/meningitis_and_coma_as_the_first_manifestation_of_juvenile_angiofibroma.htmlhttp://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_4_number_1_37/article/meningitis_and_coma_as_the_first_manifestation_of_juvenile_angiofibroma.htmlhttp://jkms.org/fulltext/html/jkms-21-773.htmlhttp://emedicine.medscape.com/article/872580-overview#showall


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Angiofibroma Nasofaring Presentation