Juvenile Nasopharyngeal Angiofibroma: The Expanded Endonasal Approach
Bibliographic record
Abstract
BACKGROUND: Juvenile nasopharyngeal angiofibroma (JNA) is a benign but locally aggressively vascular tumor that may involve the skull base and extend intracranially. Endoscopic excision has become the new standard for smaller tumors but remains a challenge for large tumors, leading some to advocate radiation therapy. We reviewed our experience managing JNA, specifically with respect to utility of the expanded endonasal approach (EEA) for lesions with skull base and intracranial extension. METHODS: All cases of JNA at the University of Pittsburgh Medical Center from 1995 to 2006 were reviewed with respect to tumor size and location, vascular supply and results of embolization, skull base involvement and intracranial extension, surgical approach, blood loss, intraoperative and postoperative complications, and recurrence. RESULTS: Thirty-one cases of JNA were identified. The majority of tumors were completely excised using the EEA, regardless of size or extension into adjacent compartments. Surgical excision of some tumors with intracranial blood supply was staged. Recurrence rates were not associated with extent of tumor or surgical technique. Long-term morbidity was minimal. CONCLUSION: Most JNA, regardless of tumor extent, may be completely excised using EEA alone or in combination with minor sublabial incisions avoiding the morbidity associated with larger open approaches or postoperative radiation therapy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".