Juvenile XXXX : a revised staging system.

@entity1 @entity5 @entity18871
OBJECTIVES: To discuss the shortcomings of current staging systems and to suggest modifications according to new surgical methods and data. STUDY DESIGN: A retrospective chart review. METHODS: The medical records of 36 @entity1 , all of whom underwent resection of juvenile @entity18871 by external or endonasal approach between 1983 and 2002, were reviewed retrospectively. Follow-up period of @entity1 ranged from 3 to 7 years (mean, 4.5 years). @entity5 extent, sites and rate of persistent disease were analyzed and compared with the literature. RESULTS: Persistent or recurrent disease was found in 12 of the 36 @entity1 (33%). The primary @entity5 of these 12 cases invaded one or more anatomic region beside nasopharynx: the base of the pterygoid process in 9 cases (75%), the infratemporal fossa in 4 (33%), the pterygomaxillar fossa in 4 (33%), and the sphenoid sinus in 2 cases (17%). Involvement of the pterygoid process base was observed in only 3 of the 24 @entity1 without persistent disease, whereas it was found 10 out of 12 @entity1 with persistent disease. CONCLUSIONS: Advances in radiographic imaging, embolization, and surgical methods of treating @entity18871 have changed the sites associated with a high risk for persistent disease or morbidity. These changes have made it necessary for the authors to devise more appropriate classifications and, subsequently, several new staging systems were gradually introduced. Recent technological advances, particularly angled endoscopes, have resulted in improved exposure. In the light of all these recent advances, data from our series, and the literature, we suggested a new classification for determining the risk of persistent disease, choosing the appropriate surgical method, and for maintaining uniformity.
