phenylephrine-hydrochloride and Angiofibroma

Juvenile nasal angiofibroma (JNA) is a benign, fibro-vascular, locally aggressive tumor with invasive growth patterns and high probability of recurrence. JNA present exclusively in adolescent boys between 9 and 19 years of age, total about 0.05% of head and neck tumors. 143 patients with JNA had been treated surgically from 2002 to August 2018 at N.N. Burdenko National Medical Research Center for Neurosurgery. All patients (primary and recurrences) were males of the age 7-38 years (16.1 [11.3; 19] years). The age of patients with primary JNA was less than 18-year old, of the exception of presenting case. There are more and more publications about case reports and successful treatment series of JNA. However, after detailed review the literature we revealed some kind of confusion: there are case reports of JNA in women and elderly people, JNA in patients with some systemic diseases, JNA with different places of origin and different morphological structure. In this paper we present a very rare case of 38 year-old male with pure primary JNA, accidentally diagnosed on CT and pathologically proven after endoscopic removal. This case confirms the possibility of detecting the JNA in adult men and explains why proper diagnosis of angiofibromas is necessary. The unique case and the literature review are presented.. Юношеская ангиофиброма основания черепа (ЮАОЧ) - это редкая быстрорастущая доброкачественная сосудисто-фиброзная опухоль, характеризующаяся локальным деструирующим ростом и высоким процентом рецидивов. Она встречается в 0,05% случаев всех опухолей головы и шеи, у пациентов подросткового возраста (9-19 лет) [1-3]. В НМИЦ нейрохирургии им. акад. Н.Н. Бурденко накоплен большой опыт лечения пациентов с ЮАОЧ: с 2002 г. по август 2018 г. были прооперированы 143 пациента. Все пациенты как с первичной опухолью, так и с ее рецидивом были мужского пола, в возрасте от 7 до 38 (16,1 [11,3; 19]) лет. Возраст первичных пациентов не превышал 18 лет, за исключением одного пациента, у которого ЮАОЧ впервые была выявлена в возрасте 38 лет. В последние годы появляется все больше публикаций успешного лечения пациентов с данной патологией. Однако при ближайшем рассмотрении оказалось, что в литературе отмечается некая путаница: описания случаев юношеских ангиофибром у женщин, а также у мужчин зрелого и пожилого возраста, ангиофибром различной локализации, при различных системных заболеваниях и с разным гистологическим строением. В данной статье мы приводим редкое клиническое наблюдение пациента 38 лет с истинной первичной ЮАОЧ, случайно обнаруженной при плановом обследовании по данным КТ. После эмболизации сосудов опухоли пациент был успешно прооперирован эндоскопически. Диагноз был подтвержден гистологически и иммуногистохимически. Приведенное наблюдение подтверждает возможность обнаружения истинной ЮАОЧ у взрослых мужчин и объясняет, почему необходима правильная диагностика ангиофибром.

Topics: Adult; Angiofibroma; Humans; Male; Neoplasm Recurrence, Local; Nose; Nose Neoplasms

Nasal obstruction is one of the most common problems seen by pediatric otolaryngologists. Prompt treatment of nasal obstruction can be critical in newborns and infants because of their obligatory nasal breathing. Older children will typically have more inflammatory, infectious, or traumatic causes of nasal obstruction. Nasal obstruction can lead to a significant decrease in the quality of life in children along with an increase health care expenditures.

Topics: Angiofibroma; Child; Choanal Atresia; Constriction, Pathologic; Diagnosis, Differential; Endoscopy; Foreign Bodies; Health Expenditures; Humans; Nasal Obstruction; Nose; Pediatrics; Quality of Life; Rhinitis, Allergic; Tomography, X-Ray Computed

Fibrous papules present clinically as benign, asymptomatic, dome-shaped, flesh colored papules on the face. Histologically, fibrous papules are characterized by fibrous stroma with fibroblasts and dilated blood vessels. Multiple variants of fibrous papules have been reported. Although scattered multinucleated cells in fibrous papules have been well described, we report a fibrous papule with abundant multinucleated ganglion-like giant cells that were immunoreactive with CD34. Recognition of such fibrous papule variants is important to avoid misdiagnosis as potentially more worrisome and/or aggressive melanocytic, soft tissue, or neural lesions that may require more aggressive treatment. Indeed, fibrous papules do not commonly appear on the differential diagnosis for lesions with multinucleated giant cells or ganglion-like cells and consideration should be given to their inclusion in the appropriate clinical setting.

Topics: Adult; Angiofibroma; CD4 Antigens; Cell Transformation, Neoplastic; Diagnosis, Differential; Giant Cells; Humans; Male; Melanoma; Nose; Risk Factors; Skin Neoplasms

Endoscopic skull base surgery has significantly revolutionized the management of skull base disease. Our review focuses on the recent literature relating to endoscopic skull base surgery emphasizing its limitations.. Current literature continues to expand the indications for endoscopic approaches to the skull base. Experience in endoscopic techniques continues to grow across the world. This is due in part to advances in instrumentation and technology, improvements in technique and, more importantly, an increase in the number of surgeons with training in endoscopic techniques. Long-term outcome data remain sparse.. The limitations in endoscopic skull base surgery have not been reached. Increasing experience and improvement in technology will likely expand current indications. Future studies should focus on outcome analysis.

Topics: Angiofibroma; Cerebral Angiography; Dura Mater; Embolization, Therapeutic; Endoscopy; Hemostasis; Humans; Magnetic Resonance Imaging; Nasopharyngeal Neoplasms; Nose; Preoperative Care; Skull Base Neoplasms

Juvenile nasopharyngeal angiofibromas (JNAs) are rare hyper vascular, benign tumours typically demonstrating a locally aggressive growth pattern. The cardinal presenting symptoms are unilateral nasal obstruction and recurrent, spontaneous epistaxis. Cases outside the adolescent male population are exceedingly rare and present a diagnostic challenge. We present the case of a man in his 30s referred to our tertiary skull base centre, presenting with left nasal obstruction. Examination showed left nasopharyngeal fullness without a discrete mass. Cross-sectional imaging detailed a 2.5×2.1×1.3 cm mass localised to his left sphenoid sinus with bony erosion. Due to the suspicion of malignancy, multidisciplinary consensus was to perform a diagnostic excisional biopsy and this revealed a JNA. He remains clinically well and asymptomatic following surgery. This case highlights the potential for subtle symptomatology in the presentation of these tumours and the challenge in diagnosing a JNA outside the adolescent male population.

Topics: Adolescent; Angiofibroma; Epistaxis; Humans; Male; Nasal Obstruction; Nasopharyngeal Neoplasms; Nasopharynx; Nose

Rhinosporidiosis is a chronic fungal inflammatory disease prevalent in India and Sri Lanka. Its manifestations are mostly nasal and extranasal lesions are relatively rare. Occasional atypical presentations of this disease lead to diagnostic dilemma. Herein we report on a case of nasopharyngeal rhinosporidiosis having extensive involvement of paranasal sinuses along with intracranial extension which mimicked radiologically as juvenile nasopharyngeal angiofibroma. To our knowledge, this is the first reported case of rhinosporidiosis having intracranial extension. We discuss the pathology, treatment and briefly review the literature of this rare disease.

Topics: Angiofibroma; Animals; Head and Neck Neoplasms; Humans; Nose; Rhinosporidiosis; Rhinosporidium

本文介绍了3例鼻内镜下等离子切除儿童鼻咽纤维血管瘤的诊疗经验。3例患儿临床表现为持续性鼻塞、打鼾伴间断性鼻出血，其中1例为10岁女童，初期曾误诊为鼻腔恶性肿瘤并给予活检。术前根据病史、体格检查、鼻内镜、CT及MRI诊断为鼻咽纤维血管瘤。术中行数字减影血管造影栓塞肿瘤供血动脉，栓塞成功后即刻鼻内镜下行鼻咽纤维血管瘤等离子全程切除术，术后病理证实为鼻咽纤维血管瘤。术后随访3~6个月，患儿均无鼻塞、鼻出血、脑脊液鼻漏、视力障碍等症状，检查未见肿物复发。.

Topics: Angiofibroma; Endoscopy; Humans; Nasopharyngeal Neoplasms; Nasopharynx; Nose

Papular scars are a recently described clinical phenotype of acne scarring characterized by papules occurring on the nose and chin. We have observed a similar presentation of nasal papules among patients seen in our clinic for acne and sought to further characterize the clinical and histopathological characteristics of this entity.. In this single-site case series, a retrospective review of electronic medical records of patients with nasal papules in association with acne vulgaris between April 2018 and April 2019 was performed. Clinical and histopathologic findings were recorded.. We identified 20 patients who presented with a similar clinical phenotype of predominantly skin-colored, dome-shaped papules concentrated on the nose and chin in association with a history of more classic facial acne vulgaris. Papular lesions were seen predominately in adolescent Hispanic males. Concomitant acne on other areas of the face was identified in 18 patients at presentation while two patients had a history of adolescent acne. Biopsies were performed for five patients. Histopathologic examination demonstrated features of fibrosis and dilated thin-walled blood vessels, typical of angiofibromas.. We present a series of adolescent patients with large, flesh-colored to erythematous papules seen predominantly on the nose. These lesions are histologically indistinguishable from angiofibromas and may represent an under-recognized yet disfiguring sequela of acne that may disproportionately affect adolescents with skin of color.

Topics: Acne Vulgaris; Adolescent; Angiofibroma; Humans; Male; Nose; Retrospective Studies; Skin

Juvenile nasopharyngeal angiofibromas (JNAs) are highly vascular and benign tumors that can expand into the skull base. Delay of treatment can result in intracranial invasion, requiring extensive open approaches such as a facial translocation, maxillary swing, or an orbitozygomatic craniotomy. We describe a single-stage, combined endoscopic and transoral approach on a 14-year-old male with extensive high-stage dumbbell-shaped JNA involving the infratemporal fossa, orbit, buccal space, and intracranial extension into Meckel's cave. Successful resection of the tumor and good postoperative outcome was achieved. A transoral approach allowed for greater access to the infratemporal fossa, where endonasal resection was not possible, allowing for improved visualization, greater traction, and dissection. In select highly staged JNAs with significant lateral extension and intracranial involvement, successful and complete resection may be accomplished with this combined approach. Utilization of this approach avoids the morbidity of more invasive open approaches.

Topics: Adolescent; Angiofibroma; Craniotomy; Endoscopy; Humans; Male; Nasopharyngeal Neoplasms; Nose

Lobl M, Zandieh SO. Obstructive sleep apnea as the first presentation of juvenile nasal angiofibroma. J Clin Sleep Med. 2019;15(9):1373-1375.

Topics: Adolescent; Angiofibroma; Humans; Magnetic Resonance Imaging; Male; Nose; Nose Neoplasms; Sleep Apnea, Obstructive

Although transnasal endoscopic resection (TER) of juvenile angiofibroma (JA) is unquestionably less invasive than traditional external approaches, several endonasal and neurovascular structures are sacrificed during the procedure. The aim of this study was to evaluate long-term neurological morbidity and related quality of life following TER of JA.. Retrospective cohort study.. All patients who underwent TER for JA at the Unit of Otorhinolaryngology-Head and Neck Surgery of the University of Brescia from 1994 to 2016 were contacted to know their availability to undergo a battery of tests aimed to assess lacrimal secretion (Schirmer test), impairment of sensitive nerves (electrophysiological threshold test), and impact on quality of life of tearing reduction and sensitivity impairment with the Ocular Surface Disease Index (OSDI) and visual analogue scale (VAS) (0-10), respectively.. Thirteen patients were included. Mean follow-up was 77 months (range, 19-156 months). The median Schirmer test value was 5.5 mm and 28.5 mm for the treated and untreated sides, respectively (P = .003). Analysis of sensitivity revealed significant impairment only in the hard palate. The mean OSDI score was 6.8 (normal). The mean values of the VAS scores for hard palate, buccal mucosa, gum, and premaxillary skin were 1.7, 1.7, 1.2, and 2.3, respectively.. TER for JA can result in objective reduction of lacrimal secretion and sensitivity impairment; nevertheless, their impact on quality of life is negligible. The predictable neurological morbidity of TER should be discussed during preoperative counseling.. 4 Laryngoscope, 129:2184-2188, 2019.

Topics: Adolescent; Adult; Angiofibroma; Child; Endoscopy; Female; Head and Neck Neoplasms; Humans; Male; Nose; Postoperative Complications; Retrospective Studies; Treatment Outcome

Fibrous papule (FP) is a common benign lesion located primarily in the nose. Although its histogenesis has been marred with controversies in the past, the dermal dendrocyte is now largely accepted to be the putative cell of origin. Histopathologic diagnosis of an FP is straightforward in most cases, which shows characteristics of an angiofibroma. Several histologic variants have been described, recognition of which is important to avoid a misdiagnosis and inappropriate treatment. This review presents a historical perspective into the histogenesis, discusses the histopathologic features and potential diagnostic pitfalls of classic FP, and lists the various histologic variants and their differential diagnoses.

Topics: Angiofibroma; Humans; Nose; Skin Neoplasms

Epistaxis is the most common ENT emergency encountered in the Emergency Department. Most cases can be managed by simple anterior nasal packing. This is usually a safe and very effective option in an emergency situation, requiring minimal expertise and infrastructure. This paper describes a rare instance of a serious complication following anterior nasal packing in a case of nasopharyngeal angiofibroma.. A 27-year-old man diagnosed with nasopharyngeal angiofibroma presented to the Emergency Department with bilateral epistaxis. The patient was stabilised and anterior nasal packing was performed, which controlled the bleeding. Three hours later, the patient developed complete blindness in both eyes. Aggressive medical management was initiated immediately, but failed to restore the patient's vision.. Anterior nasal packing is a simple and minimally invasive procedure practised regularly in an Emergency Department setting. However, it can occasionally lead to serious complications such as blindness. Thus, obtaining informed consent is essential to avoid medico-legal consequences in high-risk cases.

Topics: Adult; Angiofibroma; Blindness; Epistaxis; Hemostatic Techniques; Humans; Male; Nasopharyngeal Neoplasms; Nose

Topics: Angiofibroma; Child; Humans; Male; Nose; Skin; Skin Neoplasms

Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. Almost always unilateral on diagnosis, JNAs are locally invasive and may extend across the midline, giving a false bilateral appearance; as such, true bilateral JNA is exceedingly rare. We present a recent case of true bilateral JNA.. Single case report of a patient with bilateral JNA, including clinical presentation, diagnosis, and management.. The patient presented with unilateral nasal obstruction and recurrent epistaxis. Computed tomography and magnetic resonance imaging demonstrated bilateral, noncontiguous masses. Angiography revealed independent vascular supplies from each respective side with no bilateral supply noted. The patient underwent preoperative embolization followed by endoscopic surgical removal of the larger mass; no complications were noted. Follow-up at 2 years demonstrated no recurrence or growth.. The vast majority of JNAs are unilateral, though invasive growth to the contralateral side may appear "bilateral" in presentation. Proper identification of true bilateral JNA is helpful in guiding management, wherein excision of both tumors may not be necessary.

Topics: Adolescent; Angiofibroma; Early Detection of Cancer; Endoscopy; Epistaxis; Humans; Magnetic Resonance Imaging; Male; Nasal Obstruction; Nasopharyngeal Neoplasms; Nose; Pharynx; Tomography, X-Ray Computed; Treatment Outcome

Our study was designed to compare two surgical approaches that are currently employed in the treatment of nasopharyngeal angiofibroma stages I and II.. Retrospective chart review to compare outcomes in 11 patients who underwent endoscopic resection with outcomes of transpalatal excision in 13 patients with juvenile nasopharyngeal angiofibroma (JNA) at our department between 1992 and 2008.. Academic otorhinolaryngologic referral centre.. Twenty-four patients were divided into two groups according to the surgical technique used. The transpalatal approach was followed for 13 patients, whereas the transnasal endoscopic approach was adhered to for 11. The outcome variables of intraoperative blood loss, length of hospital stay, complications, and rate of recurrence were analyzed.. Compared to the transpalatal surgery group, the transnasal endoscopic group had less intraoperative blood loss (375 ± 27 mL vs 635 ± 41 mL), the mean duration of surgery was significantly shorter (115.7 ± 7.6 minutes vs 141.5 ± 9.8 minutes), and there was a lower occurrence of complications (1 patient vs 6 patients) and a shorter length of hospital stay (4 ± 1.0 days vs 6 ± 1.5 days), but there was no significant difference in the rate of recurrence.. In JNA stages I and II, the transnasal endoscopic approach is clearly a good alternative to the transpalatal approach.

Topics: Adolescent; Adult; Angiofibroma; Child; Endoscopy; Follow-Up Studies; Humans; Male; Nasopharyngeal Neoplasms; Neoplasm Staging; Nose; Otorhinolaryngologic Surgical Procedures; Retrospective Studies; Treatment Outcome; Young Adult

Angiography is an invasive, radiological investigation of vascular system. It plays an important role within variety of diagnostic tools in head and neck pathologies. In selected cases with well defined tumor supply vessels, angiography may be combined with intravascular obliteration. This possibility widen indications, which comprise diagnostic arteriographies - visualization of blood supply and extension of vascularization; therapeutic and diagnostic arteriographies - palliative or radical in character, dependent on pathology; and therapeutic angiographies as adjuvant therapy prior to surgical treatment. Authors present their experience with endovascular techniques application in head and neck pathologies. Material comprised 59 angiographies performed in patients treated at Otolaryngology Department at Poznań University of Medical Sciences between 2000-2007. In conclusion authors emphasize advantages and disadvantages, as well as, the role of the endovascular treatment in head and neck surgery.

Topics: Angiofibroma; Embolization, Therapeutic; Face; Head; Humans; Nasopharyngeal Neoplasms; Neck; Nose; Radiography; Vascular Malformations

Juvenile nasopharyngeal angiofibromas are highly vascular, non-encapsulated tumours affecting predominantly young males. These lesions are benign histologically but they may become life-threatening with excessive bleeding or intracranial extension.. The surgical approaches to 22 male patients with nasopharyngeal angiofibromas are reviewed. A modification of midfacial degloving performed without rhinoplasty incisions and lateral osteotomies is described.. The patients' ages ranged between 9 and 26 years (mean 14.9). Three stage I tumours, 8 stage II tumours, 6 stage III tumours and 5 stage IV tumours were included into this study. All stage I lesions and one stage II lesion were treated via transnasal endoscopic approach. A modified midfacial degloving approach was used for the removal of seven other stage II lesions, all six stage III lesions, and three stage IV lesions. A combined midfacial degloving-infratemporal fossa Fisch C-transcranial approach was the route chosen for the remaining two stage IV lesions. The complications encountered in the postoperative course include temporary facial palsy in one patient (following a Fisch C infratemporal resection), mild crusting in the nasal cavity in 8 patients, and facial paraesthesia in 6 patients whose tumours were resected via midfacial degloving, and rupture of the subpetrous part of the internal carotid artery in one patient.. The suggested treatment of juvenile nasopharyngeal angiofibroma consists of an endoscopic transnasal approach for early stage lesions, and a modified midfacial degloving for almost all of the advanced lesions. The latter approach is very useful considering surgical exposure, duration of surgery, cosmetic outcome, and morbidity. It can be combined with an infratemporal approach or craniotomy if necessary.

Topics: Adolescent; Adult; Angiofibroma; Carotid Artery Injuries; Carotid Artery, Internal; Child; Craniotomy; Endoscopy; Facial Paralysis; Frontal Bone; Humans; Male; Nasopharyngeal Neoplasms; Neoplasm Staging; Nose; Nose Diseases; Oral Surgical Procedures; Paresthesia; Postoperative Complications; Retrospective Studies; Rupture; Temporal Bone; Treatment Outcome

This study presents a comparative analysis of current surgical approaches for the treatment of nasopharyngeal angiofibroma, including extension of tumors, postoperative morbidity, complications, and recurrence rate. Twenty-four patients who underwent surgery with the diagnosis of juvenile nasopharyngeal angiofibroma at our department between 1993 and 2003 were retrospectively reviewed according to their clinical presentation, surgical approaches, and prognosis. Radkowski staging scale was used for staging tumors. The transpalatal approach was used in 10 patients before 1999 with tumor stages between Ia and IIa. Transpalatal fistula was encountered in one. Nine patients underwent transnasal endoscopic surgery after 1999 with tumor stages between Ia and IIIa. Lateral rhinotomy in four patients and a degloving approach in one patient were used with tumor stages between IIa and IIIa; postoperative nasal crusting was the most annoying problem in these groups. Recurrent tumor was seen in only one patient who had undergone the transpalatal approach in the 12- to 56-month follow-up period. In this regard, the transnasal endoscopic approach can be used successfully in place of the transpalatal approach due to the former's lesser surgical morbidity and wide lateral exposure of the field in patients with nasopharyngeal angiofibroma. Also, many patients who underwent lateral rhinotomy for the removal of stage IIa, IIb, and IIIa tumors can successfully be treated using the transnasal endoscopic approach. In tumors that extend, infratemporal fossa lateral rhinotomy and degloving approaches provide the optimal exposure but have higher potential for morbidity than does transnasal endoscopic surgery.

Topics: Adolescent; Adult; Angiofibroma; Endoscopy; Follow-Up Studies; Humans; Male; Nasopharyngeal Neoplasms; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Nose; Nose Diseases; Oral Fistula; Palate; Postoperative Complications; Prognosis; Retrospective Studies

To investigate the efficacy and the surgical techniques of transnasal endoscopic procedure for juvenile nasopharyngeal angiofibroma (JNA).. Twenty-one nasopharyngeal angiofibroma patients were treated using transnasal endoscopic approach. They were divided into group A (without intracranial extension) and group B (minimal intracranial extension) according to the staging of Sessions. The patients were treated mostly with endoscopic surgery. In two midfacial operations cases, endoscopy was also used. The staging, average blood loss during surgery, tumor residual, and (or) recurrent tumor were evaluated.. Group A (19 cases) had an average blood loss of 1000 ml. Nineteen patients had no residual or recurrent tumor over a follow-up of 8-24 months. Group B (2 cases) had an average blood loss of 1500 ml. One of the patients had minimal residual tumor around the cavernous sinus, but showed no progression over a follow-up of 2 years. Another patient had no residual or recurrent tumor over a follow-up of 8 months.. The data suggests that transnasal endoscopic surgical techniques can be used to treat JNA which either limited to nasal and nasopharyngeal cavities or and the tumor with sphenoid and ethmoid invasions and even minimal intracranial extension.

Topics: Adolescent; Adult; Angiofibroma; Child; Endoscopy; Humans; Male; Nasopharyngeal Neoplasms; Nose; Retrospective Studies; Young Adult

Topics: Adolescent; Angiofibroma; Endoscopy; Humans; Male; Nasopharyngeal Neoplasms; Nose; Otorhinolaryngologic Surgical Procedures

To assess the feasibility of passive marker computer-aided surgery in a single institution, we performed 22 procedures in 21 patients with disorders including sinonasal tumors (n = 9), fungal sinusitis (n = 4), recurrent polyps (n = 3), chronic sinusitis (n = 3), and cerebrospinal fluid rhinorrhea (n = 2). Passive marker computer-aided surgery was successful in 19 of the 21 patients. The accuracy was on the order of 1.35 mm. Probe conversion, rotation, and cordlessness were helpful in all 19 cases. The system helped with landmarks (n = 14), margins (n = 7), skull base (n = 6), orbit (n = 5), and approach (n = 4). Computer-aided surgery accurately confirmed the location of an instrument and demonstrated tumor-normal tissue interfaces. It aided the surgeon in procedures on the sinonasal area and cranial base. The potential advantages of a passive marker system as compared with other available technologies center around the ability to convert and/or rotate virtually any instrument to a cordless imaging probe on demand during the operation.

Topics: Angiofibroma; Cerebrospinal Fluid Otorrhea; Cerebrospinal Fluid Rhinorrhea; Craniopharyngioma; Endoscopy; Humans; Magnetic Resonance Imaging; Meningeal Neoplasms; Meningioma; Nasopharyngeal Neoplasms; Nose; Otorhinolaryngologic Surgical Procedures; Paranasal Sinuses; Pituitary Neoplasms; Safety; Sinusitis; Skull Base; Surgery, Computer-Assisted; Tomography, X-Ray Computed

The angiomatous polyp corresponds to the vascular compromised nasochoanal part of a sinochoanal polyp. We describe the MRI characteristics of such lesions in four patients. All patients had an angiomatous polyp, in three cases as part of an antrochoanal polyp, and in one case as part of a sphenochoanal polyp. The unenhanced MR images depicted the typical appearance of a sinochoanal polyp, hypointense on T1-weighted and hyperintense on T2-weighted images. On gadolinium-enhanced MR images, the sinusal part showed little or no peripheral enhancement; however, the nasochoanal part, corresponding to the angiomatous polyp, showed strong enhancement. An angiomatous polyp mimics a hypervascular mass lesion on enhanced MR studies. The anatomic location and association with a sinusal polyp allows the correct diagnosis.

Topics: Adolescent; Adult; Angiofibroma; Diagnosis, Differential; Female; Humans; Image Enhancement; Magnetic Resonance Imaging; Male; Maxillary Sinus; Maxillary Sinus Neoplasms; Nasal Polyps; Nasopharynx; Nose; Nose Neoplasms

To evaluate the result of sublabial transnasomaxillary approach (STA) as a route for removal of juvenile nasopharyngeal angiofibroma (JNA). Eleven young male patients with angiofibroma underwent removal via the sublabial transnasomaxillary approach. This technique is described in detail. There was neither major operative nor postoperative complication. One patient developed dacryocystitis. Long term follow-up longer than 18 months in 5 patients, showed no recurrence. This technique is useful for removal of angiofibroma because it enables the surgeon to gain extensive exposure of maxillary, ethmoid and sphenoid sinuses and to control sphenopalatine and internal maxillary arteries, without risk of palatal dysfunction or of oronasal fistula. Other advantages comprise the lack of a facial scar, nasal septal scar and bilateral premaxillar numbness, and good postoperative assessment.

Topics: Adolescent; Adult; Angiofibroma; Child; Female; Humans; Male; Maxilla; Nasopharyngeal Neoplasms; Nose; Otorhinolaryngologic Surgical Procedures; Retrospective Studies; Sensitivity and Specificity; Treatment Outcome

The nose, along with the anterior wall of the maxillary antrum in continuity with the inferior orbital rim, can be transposed on a skin pedicle. This procedure can be combined with a Le Fort I osteotomy and mandibulotomy to gain access to, and to create a space for the delivery of anterior, middle and retromaxillary skull base lesions. The technique is illustrated by a case report and the merits and versatility of this technique are discussed.

Topics: Adolescent; Angiofibroma; Craniotomy; Facial Bones; Humans; Male; Maxilla; Nose; Orbit; Osteotomy, Le Fort; Skull Base Neoplasms

Topics: Angiofibroma; Diagnosis, Differential; Epistaxis; Female; Humans; Middle Aged; Nasal Polyps; Nasopharynx; Nose; Nose Neoplasms; Paranasal Sinus Neoplasms; Paranasal Sinuses

We present a surgical procedure that provides exposure to the medial part of the orbit, the interorbital space, and the nasopharynx. A midline incision of the nose is followed by a pedicled osteotomy of the lateral nasal wall and the medial wall of the orbit in one piece. This transnasal approach provides good exposure to the medial parts of the craniofacial junction to remove foreign bodies or benign tumors.

Topics: Angiofibroma; Eye Foreign Bodies; Humans; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Orbit; Surgery, Plastic; Wounds, Gunshot

Topics: Angiofibroma; Coloring Agents; Humans; Laser Therapy; Nose; Skin Neoplasms