Otolaryngology- Head and Neck Surgery Volume 121 Number 2 Scientific Sessions--Monday P121 9:30 to 10:18 AM MCC Room 270 9 Contributed Papers: General STAN E THAWLEY MD; AMELIA F DRAKE MD (moderators) 9:30 am New Association of Idiopathic Adult Onset Laryngo- tracheal Stenosis JAMES H LIU MD (presenter); MICHAEL J RUTrER MD; DANA T LINK MD; ROBIN T COl-raN MD; Cincinnati OH Objectives: Progressive idiopathic laryngotracheal steno- sis is rare in adults. There are no classified genetic disorders with adult onset progressive airway stenosis as a main com- plication. We describe a new disorder with idiopathic adult onset laryngotracheal stenosis, characteristic facial features, short stature, and arthropathy. Methods: We present 5 cases of unrelated individuals, both male and female, who have been seen at our institution for adult onset progressive airway stenosis. Complete evaluations were also done by Human Genetics. Results: Laryngotracheal stenosis was severe enough in 4 of the 5 patients that a tracheotomy was required. Each patient had a distinct facial appearance that included deeply set eyes, bushy eyebrows, and a flat midface. In addition, they all had short stature and arthropathy. None of our patients had any evidence for an infectious, inflammatory, or metabolic cause for their signs and symptoms. Complete genetic testing revealed no known association with any previously described syndromes. Conclusion: Our patients have a previously undescribed disorder consisting of adult onset progressive laryngotracheal stenosis, distinct facial anomalies, short stature, and joint lim- itation. 9:38 AM Management of Juvenile Nasopharyngeal Angiofibroma PETER BAPTISTA MD PHD (presenter); GUSTAVO ALFARO MD; MARILINA MAZZEO MD; LUIS A MURO MD; Caracas Venezuela Objectives: To record the occurrence of juvenile nasopha- ryngeal angiofibroma (JNA) in patients who were hospitalized at the ENT Service of the Hospital Universitario de Caracas, Venezuela, in order to demonstrate the utility of diagnostic methods and our experience in the therapeutic management of these patients. Methods: Twenty male patients with the diagnosis of JNA hospitalized in the Otolaryngology Department of the Hospital Universitario de Caracas, Venezuela, between 1996 to 1998, were included. Patients were studied with CT scans, MRI, and bilateral carotid angiography. Preoperative embolization was used in 11 of 19 (8 primary surgery; 3 for recurrence). In 6 patients, internal maxillary artery ligation was performed before tumor resection during the same surgi- cat procedure. Primary surgery was performed in 95% of these patients. Radiotherapy was used with 1 patient in stage IV (5%). Different surgical approaches included lateral rhinotomy, facial degloving, and bicoronal craniotomy when neurosurgical support was required. Results: Applying the Chandler et al staging format, there were 2 patients with stage I, 7 stage II, 8 stage III, and 3 stage IV tumors. Of the 20 patients, 19 were undergoing primary surgery, and I was undergoing surgery for a recurrence (diag- nosed at 6 months following surgical treatment). This case required an additional surgery. Preoperative embolization suc- cessfully reduced intraoperative blood loss. No embolization- related complications were found. Follow-up of the remaining 18 has shown no recurrence of disease throughout radiologi- cal control. Intraoperative bleeding average was of 1500 mL, with a range from 400 to 7000 mL. No major postoperative complications were found. The only case treated with radio- therapy has no further tumor growth. Conclusion: JNA is a rare benign tumor of fast and expan- sive growth exclusively seen in male teenagers. All patients clinically suspected to have this pathology must be studied with CT scans. We are convinced that embolization minimizes the intraoperative blood loss. Cosmetic results following sur- gical procedure therapy were excellent. Radiotherapy remains as a palliative procedure to avoid further extension. 9:46 AM Cystic Hygroma: Predictive Factors for Recurrence LAWRENCE J FLIEGELMAN MD (presenter); MICHAEL A ROTH- SCHILD MD; DAVID RICHARD FRIEDLAND MD; MARGARET 8RANDWEIN ME).' New York NY; New York NY; Hastings Hudson NY; New York NY Objectives: Cystic hygromas are benign, congenital prolif- erations of lymphatic tissue. Although often found to be well circumscribed when surgery is undertaken in early childhood, complete surgical excision can be difficult when the lesion is infiltrative. This study retrospectively evaluates the resectabil- ity, gross appearance, postoperative recurrence rates, and his- tology of cystic hygromas in the head and neck region. Methods: A retrospective chart review was conducted at a tertiary care institution, covering the years 1991 through 1998. Seventeen patients were identified who underwent 32 surgical resections of cystic hygroma lesions involving the head and neck. This review evaluated the recurrence of cystic hygroma after surgery, as well as the gross operative impression and pathological findings, both gross and histological. Results: Six of 17 patients had recurrences of their cystic hygromas after surgery. All 6 of these patients were found to have nonencapsulated, infiltrative lesions intraoperatively and on histopathological examination. Of the remaining 11 patients without recurrence, only 2 demonstrated nonencapsu- lated, infiltrative lesions grossly and histologically. The other 9 patients without recurrence had encapsulated lesions by