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156

KUANetal.

TABLE XVII.A.1 Evidence surrounding open versus endoscopic surgery for JNA.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Reyes et al. 351

Recurrence rates 1. Endoscopic approach had significantly lower rates of recurrence than open approach for all tumor stages 2. Advanced tumors had significantly higher recurrence rates than low-stage tumors

2019 2

Meta-analysis Nine studies of

patients with JNA treated with open versus endoscopic surgical approach ( n = 362)

Cohen-Cohen et al. 780

2021

4

Case–control

Patients who

1. Surgical

1. 82% of cases were managed endoscopically in the modern cohort versus 8% in historical cohort 2. Significantly less blood loss in endoscopic cohort 9% recurrence rate versus 24% recurrence rate comparing endoscopic to historical open cohort 1. Midfacial degloving is a good approach for tumors that involve the infratemporal fossa and orbit 2. Median 600 mL blood loss, median 105 min operative time, two episodes of epistaxis, three patients with residual disease, one patient with recurrent disease 1. 72% of patients had GTR 2. 28% had residual or recurrent tumor that required reoperation 3. Low-stage tumors had 1. 1500 mL mean blood loss 2. 66.7% cases of GTR 3. Nine patients with recurrence or residual tumor 1. Open approach had significantly higher postoperative complications 2. No significant difference in rate or size of persistent disease between open and endoscopic groups 1. 42% underwent open resection of extracranial tumor versus 58% with endoscopic 2. 72% had no evidence of recurrence/residual, management of recurrence included observation, radiation, and excision in symptomatic patients (Continues) 100–400 mL blood loss; advanced tumors had 500–2500 mL blood loss

underwent surgical resection of JNA from 2005 to 2019

approach

2. GTR 3.

compared to 65 historical cases ( n = 22)

Intraoperative blood loss

4. Recurrence

Schofield et al. 812

1. Blood loss 2. Operative time 3.

2021

4

Retrospective case series

Patient series who underwent

midfacial degloving for resection of JNA ( n = 21)

Complications 4. Residual and recurrent disease

Szyfter et al. 779

2021

4

Retrospective case series

Patients who

1. GTR 2. Rates of

underwent either open or endoscopic resection of JNA ( n = 71)

residual or recurrent tumor 3. Blood loss

Sousa et al. 769

1.

2019 4

Retrospective case series

Patients with JNA

Intraoperative blood loss

treated with open surgical approaches ( n = 27)

2. GTR 3. Recurrence 1. Postoperative complications 2. Disease persistence 3. Sizeof persistent disease

Epprecht et al. 813

2018 4

Retrospective case series

Patients with JNA: four treated with open approach

versus nine treated endoscopically ( n = 13)

Rupaet al. 814

1. Surgical

2018 4

Retrospective case series

Patients with advanced (Radkowski IIIa or IIIb) JNA( n = 45)

approach (openvs. endoscopic)

2. Disease

recurrence