Early Postoperative CT Scanning for Juvenile Nasopharyngeal Angiofibroma: Detection of Residual Disease
Romain E. Kaniaa,
Elisabeth Sauvageta,
Jean-Pierre Guichardb,
René Chapotb,
Patrice Tran Ba Huya and
Philippe Hermana
a Department of Otorhinolaryngology-Head and Neck Surgery, Assistance Publique-Hôpitaux de Paris, Paris VII University, Lariboisière Hospital, France
b Department of Radiology, Assistance Publique-Hôpitaux de Paris, Paris VII University, Lariboisière Hospital, France
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FIG 1. True-negative result on CT scans.
A and C, Preoperative coronal (A) and axial (C) images show JNA.
B and D, Postoperative enhanced coronal (B) and axial (D) images illustrate a normal aspect of early postoperative CT when no RD is identified. There is no enhancement at the preoperative location of JNA. Hemostatic material mixed with blood is seen in the postoperative cavity.
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FIG 2. True-positive result. Early postoperative enhanced helical CT reveals RD.
A and B, Coronal (A) and axial (B) images of show RD on the lateral edge of the pterygoids (arrow).
C and D, Coronal (C) and axial (D) images show RD in the pterygoid muscles (arrows).
E and F, Coronal (E) and axial (F) images show RD in the foramen lacerum (arrow).
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FIG 3. False-positive result. Suspected RD at the base of the pterygoids.
A and C, Preoperative coronal (A) and axial (C) CT scans show JNA.
B and D, Early postoperative coronal (B) and axial (D) CT scans show persistent contrast with adhesive material (arrow) at the location of the initial JNA extensions. No RD was found after surgical revision.
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FIG 4. False-negative result. Axial CT scans.
A and B, Early postoperative (A) and 6-month (B) images show no evidence of RD.
C, At 24 months after original surgery, scan shows recurrence of JNA at the base of the pterygoids (arrow).
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