[Giant juvenile angiofibroma: which surgical approach?]

The juvenile angiofibroma is an uncommon, highly vascular, locally invasive, non encapsulated tumor. In spite of its benignity the above mentioned peculiarities make the therapy very hard. The estrogenic hormones and the radiotherapy were used for years but there were many iatrogenic after-effects. The preferred treatment is surgical. Many surgical approaches were used. Everyone has advantages and disadvantages. The choice may be free for tumors of small or medium size. When the tumor is very large, stage III A or more, a single approach isn't enough. A double approach is mandatory; one must be an infratemporal approach (pre o postauricular). We present a case of juvenile angiofibroma stage III B which is a good pattern of the above mentioned statements.