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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: [email protected]
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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

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