Huge nasopharyngeal angiofibroma with intracranial extension: change in the dura mater and choice of surgical management
- 13 February 2007
- journal article
- case report
- Published by Cambridge University Press (CUP) in The Journal of Laryngology & Otology
- Vol. 121 (11), 1108-1112
- https://doi.org/10.1017/s0022215107005737
Abstract
We aimed to review (1) the imaging changes in the dura mater in cases of huge, lobulated juvenile nasopharyngeal angiofibroma, and (2) the choice of surgical management.Imaging from four cases of juvenile nasopharyngeal angiofibroma showed extrapharyngeal extension of the tumour. The sphenoid sinus, sella turcica and clivus were extensively eroded, and the tumour had spread deep into the cranial fossa. In three cases, intracranial exploration was performed to treat the intracranial tumour lobule. Subsequently, the tumours were removed using extracranial approaches. No perforation of the dura mater was found in these three cases, although the dura mater in the superior orbital fissure was congested, haemorrhagic and solid. Pre-operative imaging for two cases (i.e. the first operation for one and the second operation for the other) revealed no dura mater perforation. A transantral approach via a midfacial degloving incision was used to remove these tumours completely.We conclude that change in the dura mater is a crucial indication for the choice of management. If the dura mater is intact, a transantral approach via a midfacial degloving incision may remove the tumour successfully.Keywords
This publication has 7 references indexed in Scilit:
- Surgical approaches to juvenile nasopharyngeal angiofibromaJournal of Cranio-Maxillofacial Surgery, 2006
- Denker Operation is an Effective Surgical Approach in Managing Juvenile Nasopharyngeal AngiofibromaAnnals of Otology, Rhinology & Laryngology, 2004
- Giant Juvenile Nasopharyngeal AngiofibromaJAMA Otolaryngology–Head & Neck Surgery, 2004
- Huge Lobulated Juvenile Angiofibroma: Sites of Extension and Selection of Procedures for ManagementThe Journal of Otolaryngology, 2003
- The Nature of Juvenile Nasopharyngeal AngiofibromaOtolaryngology -- Head and Neck Surgery, 2000
- Imaging for juvenile angiofibromaThe Journal of Laryngology & Otology, 2000
- Juvenile angiofibroma: the lessons of 20 years of modern imagingThe Journal of Laryngology & Otology, 1999