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Nasopharyngeal angiofibroma

nasopharyngeal angiofibroma ppt, nasopharyngeal angiofibroma
Nasopharyngeal angiofibroma also called juvenile nasopharyngeal angiofibroma12 is a histologically benign but locally aggressive vascular tumor that grows in the back of the nasal cavity It most commonly affects adolescent males3 Patients with nasopharyngeal angiofibroma usually present with one-sided nasal obstruction and recurrent bleeding


  • 1 Signs and symptoms
  • 2 Diagnosis
  • 3 Differential diagnosis
  • 4 Treatment
  • 5 Prognosis
  • 6 References
  • 7 External links

Signs and symptomsedit

  • Frequent chronic epistaxis or blood-tinged nasal discharge
  • Nasal obstruction and rhinorrhea
  • facial dysmorphism when locally invasive
  • Conductive hearing loss from eustachian-tube obstruction
  • Diplopia, which occurs secondary to erosion into superior orbital fissure and due to third and sixth nerve palsy,
  • proptosis when having intraorbital extension
  • Rarely anosmia, recurrent otitis media, and eye pain


If nasopharyngeal angiofibroma is suspected based on physical examination a smooth vascular submucosal mass in the posterior nasal cavity of an adolescent male, imaging studies such as CT or MRI should be performed Biopsy should be avoided as to avoid extensive bleeding since the tumor is composed of blood vessels without a muscular coat

Antral sign or Holman-Miller sign forward bowing of posterior wall of maxilla is pathognomic of angiofibroma

DSA digital subtraction angiography of carotid artery to see the extension of tumors and feeding vessels

Differential diagnosisedit

  • Antro-choanal polyp benign neoplasm
  • Rhinosporidiosis as bleeding point is here too
  • Malignancy—nasopharyngeal carcinoma, lymphoma, plasmacytoma, rhabdomyosarcoma
  • Chordoma
  • Nasopharyngeal cyst
  • Pyogenic granuloma


Treatment for Nasopharyngeal angiofibroma JNA is primarily surgical The tumor is primarily excised by external or endoscopic approach Medical treatment and radiation therapy are only of historical interest

External approaches:

  • transpalatine approach
  • transpalatine + sublabial Sardana's Approach
  • infratemporal Approach
  • nasal endoscopic Approach
  • transmaxillary Approach

Endoscopic approach is an excellent tool in primary and recurrent JNA, it allows visualisation and precise removal of the lesion Preoperative embolisation of tumour may be of some use in reducing intraoperative bleeding

Direct visualization is not common


Prognosis for nasopharyngeal angiofibroma is favorable Because these tumors are benign, metastasis to distal sites does not occur However, these tumors are highly vascularized and grow rapidly Removal is important in preventing nasal obstruction and recurrent epistaxis Mortality is not associated with nasopharyngeal angiofibroma4


  1. ^ 00021 at CHORUS
  2. ^ "juvenile nasopharyngeal angiofibroma" at Dorland's Medical Dictionary
  3. ^ Raphael Rubin; David S Strayer; Emanuel Rubin 2008 Rubin's Pathology: clinicopathologic foundations of medicine Lippincott Williams & Wilkins pp 1071– ISBN 978-0-7817-9516-6 Retrieved 29 June 2010 
  4. ^ Textbook of Family Medicine, 8th Edition Chapter 19 p329 Rakel, MD ISBN 978-1-4377-1160-8

External linksedit

  • SinusTumororg—an educational site that provides information about sinus tumors

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Nasopharyngeal angiofibroma

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