title: Massive angiofibroma: a surgical approach and adjunctive therapy.
abstract: A case of "end-stage" juvenile angiofibroma is presented which, by physical airway obstruction, almost killed the patient before treatment. With preoperative, adjunctive hormonal and especially embolization therapy, complete surgical removal of a 160 gm tumor was facilitated, with relatively little blood loss. A lateral transfacial approach was used that maximized the exposure created by tumor growth and minimized risks of permanently arrested growth in the severely displaced and compressed maxilla. This approach should be limited to tumors of similar size, location, and configuration; the specific indication is spread into the parotid region and out beneath or through the peripheral facial nerve.
authors.affiliation: Division of Otorhinolaryngology, University of Texas Health Science Center, San Antonio 78284.
authors.forename: B H
authors.initials: BH
authors.lastname: Haughey
authors.forename: J S
authors.initials: JS
authors.lastname: Wilson
authors.forename: C S
authors.initials: CS
authors.lastname: Barber
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology; D006258:Head and Neck Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D018219:Histiocytoma, Benign Fibrous / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D009520:New Zealand; D010139:Pacific Islands / Q000208:ethnology