Lacrimal hyposecretion: a surgical complication of juvenile nasopharyngeal angiofibroma

Rong, Zhang; Zixiang, Yi; Chang, Lin; Guoxing, Xu; Sheng, Zhang; Yuanteng, Xu; Zheming, Fang; Zhihong, Chen

doi:10.1016/j.amjoto.2007.10.006

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 29, Issue 6 , Pages 367-371, November 2008

Lacrimal hyposecretion: a surgical complication of juvenile nasopharyngeal angiofibroma

Zhang Rong, MD
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
Yi Zixiang, MD
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
- Corresponding author. Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou 350005, China. Tel.: +86 591 87982781; fax: +86 591 87982780.
Lin Chang, MD
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
Xu Guoxing, MD
- Department of Ophthalmology, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
Zhang Sheng, MD
- Department of Pathology, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
Xu Yuanteng, MD
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
Fang Zheming, MD
- Department of Imaging, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
Chen Zhihong, MD
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China

Received 23 August 2007 published online 16 June 2008.

Abstract

Purpose

The aim of this study was to evaluate lacrimal hyposecretion in the surgical management of juvenile nasopharyngeal angiofibroma (JNA) and discuss how to prevent and treat this expected surgical complication.

Materials and methods

Six cases of JNA were extirpated surgically in the last 3 years in our department. The clinical signs, results of the total tear secretion test (Schirmer I test), imaging studies, surgical findings, and pathologic changes in these cases are reviewed retrospectively.

Results

Three of the 6 cases developed an irritated dry eye on the affected side postoperatively as a result of lacrimal hyposecretion, caused by damage to or partial removal of the pterygopalatine ganglion and vidian nerve. On follow-up for 1 to at least 2 years, the clinical signs disappeared in 2 cases, whereas there was no improvement in 1 case.

Conclusions

If a JNA originates near the pterygopalatine foramen adjacent to the pterygopalatine ganglion and vidian nerve, these may be damaged or partially removed intraoperatively. The consequent lacrimal hyposecretion can be a temporary or permanent complication.

Significance

A few reports have described lacrimal hyposecretion as a surgical complication of JNA; there have been no articles reporting the prognosis of this complication or the related pathologic findings of the involved pterygopalatine ganglions. Prevention of this complication remains a clinical challenge.