Nasopharyngeal angiofibroma: (A nine-year experience)

Abstract

In a nine-year period 50 nasopharyngeal angiofibromas, of whom 13 had recurrent tumour, were treated surgically at the All India Institute of Medical Sciences, New Delhi. A new staging system according to the regions involved was used; 31 patients in whom the tumour was limited to the nasopharynx (Stage I) and those with superior spread into the ethmoid or sphenoid sinuses (Stage IIA) had their tumours removed by a transpalatal route, alone or in combination with other approaches. Tumours with lateral extensions into the pterygopalatine or infratemporal fossae or the cheek (Stage IIB), and those with simultaneous superior and lateral spread (Stage HI) underwent a transmaxillary excision (19 cases). In two of the three cases with intracranial extension (Stage IV), the tumour was removed successfully from below. There was no mortality. The usefulness of the transmaxillary approach, especially in recurrent cases, is emphasized. No adjuvant modalities were employed in this series and blood loss was acceptable.

Conformal Radiotherapy in the Treatment of Advanced Juvenile Nasopharyngeal Angiofibroma With Intracranial Extension: An Institutional Experience

“…Intracranial spread in juvenile nasopharyngeal angiofibroma has been described in various series to vary from 6% to 37.5% (11)(12)(13). The incidence of intracranial extensions is more in some Indian series as compared with Western series, primarily owing to delays in referral and poorer health care available at the primary health care facilities (13)(14)(15).…”

Benign Tumours of Nasopharynx—Revisited

“…External approaches are inferiorly-via a trans-palatal route; laterally via a transtemporal or infratemporal route; anteriorly via a maxillary swing approach [3,15]. These approaches have limited access and considerable post op morbidity due to extensive and complex mobilization [12,14,15]. Transnasal endoscopic resection of nasopharyngeal tumours obviates the need for extensive soft tissue and bony mobilization [2,6].…”

“…All cases were operated upon by the same surgeon. Patient demographics, symptomatology, radiological investigations, surgical approach, tumour histology and patient outcome were assessed [11,13,14].…”

Angiofibromas of the postnasal space: A critical appraisal of various therapeutic modalities

“…All intracranial extensions except sellar, which are rare, are reported to be approachable by lateral rhinotomy (Jones etal., 1986). In the case of massive involvement, sellar or dural extensions, the transcraniotomy approaches advocated by Fisch (1983), Antonelli et al ;1987), Spector (1988) and Tandon et al (1988) may be justified.…”