[Perioperative managements of huge lobulated nasopharyngeal angiofibromas with intracranial extensions].
OBJECTIVE
To summarize our experience of successful and failed management in 8 huge lobulated nasopharyngeal angiofibromas with intracranial extensions, and introduce some key points of perioperative treatments.


METHODS
Eight male case with an average age of 18 years, were all lobes extending into middle and/or anterior cranial fossa, in which 5 cases revealed blood supply from the internal carotid arteries and 3 cases were reoperated because of recurrence. Preoperatively, the tumor were evaluated by CT, CTA, MRI and/or MRA, and super selective embolization of the feeding arteries were crucial procedures. The combined craniofacial approaches were used to excise these tumors.


RESULTS
Five cases were removed completely, and 3 cases were removed partly in which 2 were due to serious bleeding caused by lack of DSA technique at that time and 1 were due to neglecting the tumor lobe in the sphenoid sinus of the other side.


CONCLUSIONS
Reasonable perioperative management are very important for control of intra-operative blood loss, complete remodeling of the tumor and avoiding complication.
Li
Zhichun
Z
Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China. lizhichun0322@163.com
Lin
Gongbiao
G
He
Lisheng
L
Yi
Zixiang
Z
D000293:Adolescent; D018322:Angiofibroma / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D001932:Brain Neoplasms / Q000098:blood supply / Q000556:secondary / Q000601:surgery*; D002343:Carotid Artery, Internal; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D009361:Neoplasm Invasiveness; D016896:Treatment Outcome