Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-23T14:54:01.383Z Has data issue: false hasContentIssue false
  • English
  • Français

Huge nasopharyngeal angiofibroma with intracranial extension: change in the dura mater and choice of surgical management

Published online by Cambridge University Press:  13 February 2007

ZX Yi ,
ZC Li ,
JM Cheng ,
R Zhang ,
Chang Lin ,
AD Zhou  and
ZM Fan
ZX Yi*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
ZC Li
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
JM Cheng
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
R Zhang
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
Chang Lin
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
AD Zhou
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
ZM Fan
Affiliation:
Department of Imaging, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou, China
*
Address for correspondence: Dr Yi Zixiang, First Affiliated Hospital of Fujian Medical University, 817 Road, Fuzhou 350005, China. Fax: 86 591 87982780 E-mail: yizixiang@sina.com.cn
Get access Rights & Permissions [Opens in a new window]

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

Nasopharyngeal AngiofibromaOtorhinolaryngologic Surgical ProceduresMagnetic Resonance ImagingComputed Tomography
Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 121 , Issue 11 , November 2007 , pp. 1108 - 1112
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Liang, J, Yi, Z, Liang, P. The nature of juvenile nasopharyngeal angiofibroma. Otolaryngol Head Neck Surg 2000;123:475–81CrossRefGoogle ScholarPubMed
2Eroschenko, VP. Di Fiores's Atlas of Histology with Functional Correlations, 6th edn.Philadelphia: Lippincott Williams & Wilkins, 2005;121Google Scholar
3Pick, P, Howden, R. Gray's Anatomy, 15th edn.New York: Barnes & Noble, 1995;617–18Google Scholar
4Lloyd, G, Howard, D, Phelps, P, Cheesman, A. Juvenile angiofibroma: the lessons of 20 years of modern imaging. J Laryngol Otol 1999;113:127–34CrossRefGoogle ScholarPubMed
5Lloyd, G, Howard, D, Lund, VJ, Savy, L. Imaging for juvenile angiofibroma. J Laryngol Otol 2000;114:727–30CrossRefGoogle ScholarPubMed
6Yi, Z, Li, ZC, Lin, C, Ye, S. Huge lobulated juvenile angiofibroma: sites of extension and selection of procedures for management. J Otolaryngol 2003;32:211–16Google ScholarPubMed
7Hardillo, JA, Vander Velden, LA, Knegt, PP. Denker operation is an effective surgical approach in managing juvenile nasopharyngeal angiofibroma. Ann Otol Rhinol Laryngol 2004;113:946–50CrossRefGoogle ScholarPubMed
8Cansiz, H, Guvenc, MG, Sekercioglu, N. Surgical approaches to juvenile nasopharyngeal angiofibroma. J Craniomaxillofac Surg 2006;34:3–8CrossRefGoogle ScholarPubMed
9Donald, PJ, Enepikedes, D, Boggan, J. Giant juvenile nasopharyngeal angiofibroma: management by skull-base surgery. Arch Otolaryngol Head Neck Surg 2004;130:882–6CrossRefGoogle ScholarPubMed