The surgical management of extensive nasopharyngeal angiofibromas with the infratemporal fossa approach

Abstract

Large juvenile nasopharyngeal angiofibromas are a therapeutic challenge because of their relation to major vasculature and cranial nerves at the base of the skull, and their propensity for recurrence. A classification scheme based on the growth pattern of this tumor is proposed to help the surgeon choose a procedure to access this lesion. This report describes the results obtained with the surgical removal of large (class III and IV) nasopharyngeal angiofibromas through the infratemporal fossa approach. Fourteen patients were cured and one individual developed a recurrence which was totally removed at a second procedure. Surgical morbidity was minimal and there was no mortality. Radiation therapy was necessary in only one patient who had tumor infiltration of the cavernous sinus.

Preliminary Experience with the Percutaneous Embolization of Juvenile Angiofibromas Using Only Ethylene-Vinyl Alcohol Copolymer (Onyx) for Preoperative Devascularization Prior to Surgical Resection

“…Endoscopic removal of a juvenile angiofibroma has been shown to significantly decrease blood loss during resection compared with a standard surgical approach. 17 It is difficult to compare our results with those in the series from Nicolai et al 16 Eleven of the tumors in their series were small (grade II or less), according to the classification of Andrews et al, 18 and all of the tumors were removed by a simple endoscopic approach. In contrast, our series had only 3 tumors that were small (grade II or less), and only 2 were removed by a simple endoscopic approach.…”

Management of Juvenile Nasopharyngeal Angiofibroma: A Five Year Retrospective Study

“…This study includes patients between the ages 7-19 years with an average age of 15 years [7]. Majority of patients, 9 out of 13, fell in the age group of 14-18 years, which happens to be age of most rapid growth of the patient as well as the JNA.…”

Laser-Assisted Bypass of the Internal Carotid Artery Prior to Treatment of an Extensive Angiofibroma

“…[9][10][11] In that event, refined radiological techniques allow accurate localization and timing of the occlusion. The introduction of this permanent balloon occlusion has meant a tremendous step forward in skull base surgery.…”