Surgical management of nasopharyngeal angio-fibroma.
Seventy cases of nasopharyngeal angio-fibroma are reported. Most of the patients were young adolescents between 13-24 years of age. 91% were males. The main symptoms were nose blockage and nasal bleeding, the latter was present in all the patients but the amount of blood varied from a few milliliters a time to a few hundreds of milliliters. Although angio-fibroma is benign, it invades the surrounding structures, especially the sphenoidal sinus, maxillary sinus and the ethmoidal sinuses, by expansion or by erosion. In 1/7th of the cases he palate is pushed downwards or bulges. Surgery may be the only methods to cure the disease. The main principle of surgery is complete removal of the tumour together with the periosteum to which it is attached. After thorough exposure, the extraction of the tumour should be as quick as possible, otherwise the bleeding will be profuse. As soon as the tumour has been completely removed, the hemorrhage stops spontaneously or only a minor bleeding remains. The majority of the blood supply is derived from the external carotid system, so ligation of the external carotid and injection of saline or 0.5% novocaine solution in the base of the tumour just before the extirpation of the tumour can reduce the loss of blood during the operation. However, usually a blood transfusion of 300-500 ml is necessary.
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D018219:Histiocytoma, Benign Fibrous / Q000601:surgery*; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000556:secondary / Q000601:surgery; D010521:Periosteum / Q000601:surgery