Penatalaksanaan Juvenile Angiofibroma

Oleh :

dr.Nailla Fariq Alfiani

Penatalaksanaan definitif untuk juvenile angiofibroma adalah pembedahan, tetapi hal ini sebaiknya dilakukan setelah evaluasi risiko perdarahan. Juvenile angiofibroma memang merupakan tumor jinak tetapi bersifat sangat vaskular, sehingga ada risiko perdarahan masif. Belum ada obat yang dapat menyembuhkan juvenile angiofibroma.[2,3,11,21]

Berobat Jalan

Berobat jalan dilakukan saat diagnosis awal juvenile angiofibroma melalui anamnesis, pemeriksaan fisik, dan endoskopi nasal untuk menilai gejala umum, seperti epistaksis, obstruksi hidung, atau gangguan tidur. Pencitraan berupa computed tomography (CT) atau magnetic resonance imaging (MRI) diperlukan untuk menilai ukuran, lokasi, dan ekstensi tumor. Meskipun evaluasi awal bisa dilakukan secara rawat jalan, prosedur invasif harus dilakukan di rumah sakit karena ada risiko tinggi perdarahan.[2,3,10,11]

Referensi

2. Josef Shargorodsky. Juvenile angiofibroma. UF Health. 2023. https://ufhealth.org/conditions-and-treatments/juvenile-angiofibroma
3. Shah UK. Juvenile angiofibroma. MSD Manual. 2025. https://www.msdmanuals.com/professional/pediatrics/miscellaneous-ear-nose-and-throat-disorders-in-children/juvenile-angiofibromas
5. Alla SSM, Alla D, Ratheesh V, Ramineni PK, Singh A, K V, Siddiqua A. Juvenile Nasopharyngeal Angiofibroma: A Case Report of a Rare Adolescent Head and Neck Tumor. Cureus. 2023 Jan 11;15(1):e33633. doi: 10.7759/cureus.33633.
7. Safhi FA, Al-Hazani TMI, Jalal AS, et al. FGFR3 and FGFR4 overexpression in juvenile nasopharyngeal angiofibroma: impact of smoking history and implications for personalized management. J Appl Genet. 2023 Dec;64(4):749-758. doi: 10.1007/s13353-023-00780-w.
8. Fang R, Sun W, Shi J, Xu R, Peng L, Lai Y, Chen F, Wen Y, Wen W, Li J. Risk Factors and Characteristics of the Recurrence of Juvenile Nasopharyngeal Angiofibroma: A 22-Year Experience With 123 Cases at a Tertiary Center. Clin Exp Otorhinolaryngol. 2022 Nov;15(4):364-371. doi: 10.21053/ceo.2022.01053.
9. Attya HMA, Hassouna MS, Shawky AA, Abdelmalek ME. Recurrent angiofibroma: analysis of risk factors and common sites of recurrence. Eur Arch Otorhinolaryngol. 2025 Jul;282(7):3611-3618. doi: 10.1007/s00405-025-09476-9.
10. Baba A, Kurokawa R, Kurokawa M, Srinivasan A. MRI features of sinonasal tract angiofibroma/juvenile nasopharyngeal angiofibroma: Case series and systematic review. J Neuroimaging. 2023 Sep-Oct;33(5):675-687. doi: 10.1111/jon.13116.
11. Tork CA, Winters R, Simpson DL. Nasopharyngeal Angiofibroma. StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK545240/
12. Alrusayyis D, Alotaibi JK, Almutarii R, Almolani FM, Al-Ahmari M, Alkhatib A, Almomen A. Five challenging presentations of juvenile nasopharyngeal angiofibroma: our experience in the diagnosis and endoscopic surgical management. J Surg Case Rep. 2025 Feb 28;2025(2):rjaf055. doi: 10.1093/jscr/rjaf055.
13. García-Fernández A, et al. Endoscopic surgical management of juvenile nasopharyngeal angiofibroma: Correlating tumour characteristics, risk of hemorrhage, and recurrence. Auris, Nasus, Larynx. 2024;51(6):940–946. https://doi.org/10.1016/j.anl.2024.09.004
14. Bernhard Schick, Lukas Pillong, and Silke Wemmert. The Embryological Basis of Juvenile Angiofibroma: A Unifying Hypothesis for Tumor Pathogenesis. J Clinical Research and Reports. 2025;19(5). doi:10.31579/2690-1919/521.
15. Doody J, Adil EA, Trenor CC, Cunningham MJ. The Genetic and Molecular Determinants of Juvenile Nasopharyngeal Angiofibroma: A Systematic Review. Annals of Otology, Rhinology & Laryngology. 2019;128(11):1061-1072. doi:10.1177/0003489419850194. https://journals.sagepub.com/doi/abs/10.1177/0003489419850194
17. Dewi YA, et al. Management of juvenile nasopharyngeal angiofibroma in a referral hospital in West Java, Indonesia. Althea Medical Journal. 2020;7(1):45–50. https://doi.org/10.15850/amj.v7n1.1787
18. Giorgianni A, Molinaro S, Agosti E, et al. Twenty Years of Experience in Juvenile Nasopharyngeal Angiofibroma (JNA) Preoperative Endovascular Embolization: An Effective Procedure with a Low Complications Rate. J Clin Med. 2021 Aug 31;10(17):3926. doi: 10.3390/jcm10173926.
19. Vlăescu AN, Ioniţă E, Ciolofan MS, et al. Current approach of juvenile nasopharyngeal angiofibroma: a case series. Rom J Morphol Embryol. 2022 Jan-Mar;63(1):105-111. doi: 10.47162/RJME.63.1.10.
21. Abouzeid W, et al. Multidisciplinary management of juvenile nasopharyngeal angiofibroma. Egypt J Neurol Psychiatry Neurosurg. 2021;57:167. https://doi.org/10.1186/s41983-021-00414-0

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Penatalaksanaan Juvenile Angiofibroma

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