Endoscopic resection of juvenile angiofibroma

Abstract

Juvenile angiofibroma is an uncommon, benign and extremely vascular tumor. It develops almost exclusively in adolescent males. Compared with conventional surgeries, endoscopic surgery has less intraoperative blood loss, a lower occurrence of complications and shorter length of hospital stay. Cases with extensive involvement of the infratemporal fossa and cavernous sinus, however, can be more appropriately treated by conventional surgeries. Preoperative embolization is effective, but it is difficult to embolize the branch of the internal carotid artery. In such a case, a two-surgeon technique with three or four hands is useful. A partial resection of the middle turbinate facilitates the manipulation of the sphenopalatine foramen and the pterygoid canal. The tumor invasion into the pterygoid canal should be assessed preoperatively, and should not be missed during surgery.