Juvenile Nasopharyngeal Angiofibroma: Combined Approach for Excision, Transpalatal and Endoscopic; A New Perspective

Juvenile angiofibroma is a rare, highly vascular, histologically benign but locally invasive tumour, affecting predominantly male adolescents. To describe our experience in diagnosis of angiofibroma and treatment by combined endoscopic and transpalatal route. We analysed a case series of 50 patients of nasopharyngeal angiofibroma in Fisch stages I and II who presented at our institute during a period of four years 2011-2014, their clinical presentation, their treatment by combined transpalatal and endoscopic approach, intraoperative and post operative course, complications and tumour recurrence. Patients were aged 8-26 years. All patients were treated surgically by combined approach endoscopic and transpalatal. The mean operation time was 90 min, and the mean bleeding volume was 300 ml. Only 8 % patients came with recurrence and only 10 % came with palatal perforation (fistula formation). With gratifying results we advocate this novel technique for the treatment of early to intermediate JNA.