title: Nasal juvenile angiofibroma: Current perspectives with emphasis on management.
abstract: Juvenile angiofibroma is an uncommon, benign, locally aggressive vascular tumor. It is found almost exclusively in young men. Common presenting symptoms include nasal obstruction and epistaxis. More advanced tumors may present with facial swelling and visual or neurological disturbances. The evaluation of patients with juvenile angiofibroma relies on diagnostic imaging. Preoperative biopsy is not recommended. The mainstay of treatment is resection combined with preoperative embolization. Endoscopic surgery is the approach of choice in early stages, whereas, in advanced stages, open or endoscopic approaches are feasible in expert hands. Postoperative radiotherapy (RT) or stereotactic radiosurgery seem valuable in long-term control of juvenile angiofibroma, particularly those that extend to anatomically critical areas unsuitable for complete resection. Chemotherapy and hormone therapy are ineffective. The purpose of the present review was to update current aspects of knowledge related to this rare and challenging disease. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1033-1045, 2017.
authors.affiliation: Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.|Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: López
authors.affiliation: Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK.|School of Dentistry, University of Liverpool, Liverpool, UK.
authors.forename: Asterios
authors.initials: A
authors.lastname: Triantafyllou
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Carl H
authors.initials: CH
authors.lastname: Snyderman
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hunt
authors.affiliation: Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Suárez
authors.affiliation: Professorial Unit, Ear Institute, University College London, London, UK.
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Lund
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
authors.forename: Primož
authors.initials: P
authors.lastname: Strojan
authors.affiliation: Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, Georgia.
authors.forename: Nabil F
authors.initials: NF
authors.lastname: Saba
authors.affiliation: Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, UK.
authors.forename: Iain J
authors.identifier: 0000-0002-8919-8783
authors.initials: IJ
authors.lastname: Nixon
authors.affiliation: Department of Pathology, Allegiance Health, Jackson, Michigan.
authors.forename: Kenneth O
authors.initials: KO
authors.lastname: Devaney
authors.affiliation: Department of Otolaryngology, Hospital Clinic, University of Barcelona Medical School, Barcelona, Spain.
authors.forename: Isam
authors.initials: I
authors.lastname: Alobid
authors.affiliation: Department of Otolaryngology, Hospital Clinic, University of Barcelona Medical School, Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Bernal-Sprekelsen
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Ehab Y
authors.identifier: 0000-0003-3241-2440
authors.initials: EY
authors.lastname: Hanna
authors.affiliation: University of Udine School of Medicine, Udine, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rinaldo
authors.affiliation: Coordinator of the International Head and Neck Scientific Group.
authors.forename: Alfio
authors.initials: A
authors.lastname: Ferlito
mesh_terms: D018322:Angiofibroma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D006801:Humans; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*
keywords: embolization; endoscopy; juvenile nasopharyngeal angiofibroma; sinonasal tumors; surgery