Juvenile Nasopharyngeal Angiofibroma: The Update Concept of Diagnosis and Therapy

Juvenile nasopharyngeal angiofibromas frequently require surgery of the paranasal sinuses as well as of the sellar region. This demands a close interdisciplinary cooperation before, during, and after the intervention (Samii and Draf 1989). The symptoms depend on the size of the tumor. Nasal obstruction, nasal speech, cheek swelling, dislocation of orbital contents, recurrent middle ear effusions, and headache have been the most frequent ones in our seven fairly extended cases, operated on over the past 5 years. Recurrent bleeding occurred less commonly, as one might expect. In only one case was a cranial nerve deficit, namely a deterioration of vision, observed. This recovered completely following optic nerve decompression after microsurgical tumor removal. In three cases intracranial extension was obvious.