[Surgical strategies in intracranial invasion of juvenile angiofibroma of the nasal pharynx].
The author proposes a new policy of surgical treatment of juvenile nasopharyngeal angiofibroma (JNPAF) with intracranial growth based on differential application of combined operations in two variants depending on the direction of the intracranial growth. A total of 12 patients were operated. In 10 patients the tumor invaded some parts of the facial skeleton and lateral part of the cavernous sinus. A complete removal of the tumor in these patients was carried out at microsurgical operation on the base of the skull in combination with the modified operation by Moor. One of the patients died on postoperative day 2. In 2 of 12 patients the tumor infiltrated the cavernous sinus. Neurosurgical operation was made to occlude intercavernous parts of the internal carotid artery for achievement of a complete removal of the tumor in combination with two operations: microsurgical operation on the base of the skull and the modified operation by Moor. The author emphasizes special importance of application of special components of general anesthesia (controlled hypotension, dehydration therapy), some medical equipment (an operational microscope, a drill, diathermocoagulation and suction) and in some cases special preoperative preparation for a complete removal of the tumor.
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D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000000981:diagnostic imaging* / Q000601:surgery*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D002533:Cerebral Angiography; D002648:Child; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D009361:Neoplasm Invasiveness; D019635:Neurosurgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed