비인강에의 새로운 Hemipalatal Approach
A New Hemipalatal Approach to the Nasopharyngeal Cavity

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서울대학교 의과대학
Seoul J Med 1984;25(4):578-583
The juvenile nasopharyngeal angiofibroma is
an uncommon, highly vascular, locally invasive,
non·encapsulated tumor of adolescent males. In
the treatment of the nasopharyngeal angiofibro'
rna, surgery is considered to be the method of
choice. However, due to its relative anatomical
inaccessibility, severe extension, and difficulties
in controlling the bleeding, the successful exci·
sion of the nasopharyngeal angiofibroma is
difficult with high rate of recurrence. Many
surgical approaches and their modifications were
proposed for direct visualization of the nasopharynx
and wide exposure of the operative field
so as to shorten the operation time with significant
reduction in blood loss. These include transpalatal
nasopharyngotomy, lateral rhinotomy
(Denker, 1926), sublabial transantral approach
(Allen & Siegl , 1981; Anand & Conley, 1983;
Sardana, 1965), medial or lateral mandibulotmy
approach (Kremen, 1953), and neurosurgical
craniotomy approach. Two or more approaches
may be needed and complete removal in tandem
depend upon the extension of the tumor.
The authors design an approach that would
almost expose the whole extent of the tumor
and allow complete resection of the tumor under
direct vision and in this way decrease blood
loss and the possibility of leaving residual tumor.
With this approach, sublabial transantral expo
sure is possible as one stage by simple exten·
sion of the incision. Its safety was revealed by
preceding experimental study using cats. Oper·
ative procedures, advantages, and the result of
this hemipalatal flap will be discussed
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 25 No.4 (1984)
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