09-12, 10:45–11:45 (Europe/Istanbul), Pediatric Otolaryngology 1
Description This round table is submitted by the European Pediatric Skullbase taskforce from ESPO. It will explore one of the most critical challenges in managing juvenile nasopharyngeal angiofibroma (JNA): residual disease. Despite advances in endoscopic resection and embolization, complete tumor removal remains complex, particularly in cases with skull base or intracranial extension. The session will focus on how optimal planning of the initial surgery—through imaging, staging, and multidisciplinary collaboration—can reduce residual risk. It will also examine the nuances of postoperative management: Should all residual tumors be reoperated? When is imaging surveillance appropriate? Are there non-surgical alternatives for indolent residual disease? Faculty will share decision-making algorithms, long-term outcomes, and illustrative cases to help define modern standards of care.
Outcome Objectives By the end of the session, participants will be able to:
Optimize the planning of initial JNA surgery to minimize residual disease.
Identify radiologic and intraoperative predictors of incomplete resection.
Differentiate between residual and recurrent disease using imaging and clinical criteria.
Evaluate the risks and benefits of reoperation versus surveillance.
Understand current and emerging alternatives to surgical reintervention for residual JNA.
Background Residual disease in JNA remains a source of clinical uncertainty, especially when the remnant is small, asymptomatic, or surgically risky. Incomplete resection may stem from intraoperative bleeding, complex tumor extensions, or the need to avoid critical neurovascular structures. Not all residual lesions behave aggressively; some remain stable for years. This symposium will provide a critical overview of strategies to reduce residual disease risk from the outset and explore evidence-based approaches to managing remnants. The discussion will help clinicians move beyond a binary “operate or not” framework toward a personalized, risk-adapted model of care.
To examine the clinical and surgical management of residual juvenile angiofibroma, from optimizing initial surgery to defining when reoperation, imaging surveillance, or non-surgical approaches are most appropriate.
Pediatric otolaryngologist at Necker-Enfants Malades hospital in Paris, full professor at Université Paris Cité. Specialised in pediatric otology (cholesteatoma, vestibular diseases, CI) and skull base surgery with neurosurgical team. Fondamental research on the vestiular system in mouse models and children, with a focus on gene therapy and multi-sensory integration. Expertise in surgical education and simulation models (surgical videos, 3d-printing, virtual reality, OSATS) and deputy director of the school of surgery of Paris.
- Management of unilateral hearing loss in children: a global perspective
- International Pediatric Balance Network (IPBN) Session Vestibular Testing in the Pediatric Population: New Indications and Approaches
- Skull base management in the child
- Pediatric cholesteatoma follow-up, why is it different than adult?
Nikolaus Wolter is a double board-certified pediatric otolaryngologist at the Hospital for Sick Children and associate professor in the Department of Otolaryngology – Head & Neck Surgery, Temerty Faculty of Medicine.
Romain Luscan is a pediatric otolaryngologist at Necker – Enfants Malades Hospital in Paris, France. He is particularly involved in the diagnosis and treatment of pediatric head and neck masses and in airway surgery.
In addition to his clinical work, Romain Luscan is a PhD student in Florent Ginhoux's lab (Institut Gustave Roussy, U1015), where he studies the impact of the myeloid microenvironment on the development of pediatric rhabdomyosarcoma.
Marco Ferrari serves as Associate Professor at the University of Padova (Padova, Italy) and Consultant at the Padova University Hospital (“Azienda Ospedale Università Padova”; Padova, Italy). He trained in Brescia, Italy, and complete research fellowship in Toronto (Ontario, Canada) and Padova. His main interests are head and neck oncological surgery and ventral skull base surgery, with special interest for sinonasal, salivary, and mesenchymal cancers management. He authored a number of book chapters and peer-reviewed publications, and serves as reviewer and member of the editorial board for several journals. He also authored the book entitled Endoscopic Transnasal Anatomy of the Skull Base and Adjacent Areas, published by Thieme.