Juvenile angiofibroma: the lessons of 20 years of modern imaging

Abstract

Seventy-two patients with juvenile angiofibroma have been investigated by computerized tomography (CT) and/or magnetic resonance imaging (MRI) over a period of 20 years. The evidence from these studies indicates that angiofibroma takes origin in the pterygo-palatine fossa at the aperture of the pterygoid (vidian) canal. An important extension of the tumour is posteriorly along the pterygoid canal with invasion of the cancellous bone of the pterygoid base, and greater wing of the sphenoid (60 per cent of patients). Distinctive features of angiofibroma are the high recurrence rate, and the rapidity with which many tumours recur. It is postulated that the principle determinant of recurrence is a high tumour growth rate at the time of surgery coupled with incomplete surgical excision. The inability to remove the tumour in toto is principally due to deep invasion of the sphenoid, as described above. In this series 93 per cent of recurrences occurred withthis type of tumour extension. A contributory cause in these patients is the use of pre-operative embolization. The treatment implications of these findings are examined.

Juvenile nasopharyngeal angiofibroma—our experience at a referral hospital

“…He also concluded that most of the tumors can be removed by the traditional/modifi ed transpalatal and lateral rhinotomy approach. Lloyd et al [8] studied 72 juvenile angiofi broma patients with computerized tomography (CT) and/or magnetic resonance imaging (MRI) over a period of 20 years. Their study indicated that angiofi broma takes origin in the pterygopalatine fossa at the aperture of the pterygoid (vidian) canal and extends posteriorly along the pterygoid canal with invasion of the cancellous bone of the pterygoid base and greater wing of sphenoid (60%).…”

Management of Juvenile Nasopharyngeal Angiofibroma: A Five Year Retrospective Study

“…A detailed history followed by thorough clinical examination of head and neck region was done. The patients were staged both clinically and radiologically prior to surgical treatment using Radkowski et al [4] and Sessions et al [5,6] classification of staging respectively. The patients were advised to undergo preoperative arterial embolization prior to surgery.…”

Transnasal Endoscopic Surgery for Resection of Angiofibroma With and Without Arterial Embolization

“…13 Endoscope surgery has no major morbidity, no scars, no injuries to nerves and vasculature, and no facial developmental problems. In addition, the length of postoperative hospital stay is significantly shorter than open approaches.…”