Nasopharyngeal angiofibroma

Nasopharyngeal angiofibroma is a very rare benign tumor that mainly affects boys and young men. For this reason, it is also sometimes referred to as juvenile nasopharyngeal angiofibroma. Although it is a benign tumor, it has a relatively fast growth and as a result, pressure destruction of the base of the skull and splanchnocranium can occur. It is a solid angioma with a rich arterial and venous component, which may have a maturing stage and turn into a fibroma over time. Histologically, we can describe it as a cleft long and thin vascular canals and fibrous stroma.

Macroscopic appearance
Macroscopically, it is a solid gray tumor.

Location
The tumor is most often located in the arch area of ​​the nasopharynx and the upper perimeter of the choan. There is a theory according to Neel, that the tumor almost always arises from the point of separation of the pterygoid process (the so-called posterolateral wall).

Clinical signs
Typical symptoms of a tumor are epistaxis, upper airway obstruction, nasal secretions, olfactory disorders, and hearing loss if the tumor invades the auditory tube area.

Diagnostics
The most suitable method for diagnosis is rhinoscopy and also CT and MRI. Carotid angiography is used to determine the arterial supply of the tumor.

Therapy
The only reliable therapy is surgical, which often leaves permanent cosmetic and functional consequences. The most common surgical approach used is the lateral rhinotomy. The transpalatinal approach is used less often. Life-threatening bleeding can occur during the operation, and therefore it is necessary to prepare for the operation - angiography to reveal the supply vessels and their selective embolization. The so-called face degloving method is used for cosmetic modifications in the facial area after removal of the tumor - it is the extraction of the middle soft part of the face cranially.

Related articles

 * Epistaxis
 * ors
 * Oropharyngeal tumors
 * Tumors of the nose and paranasal sinuses