[Juvenile nasopharyngeal fibroma. Report of experiences]

The juvenile nasopharyngeal angiofibroma is a rare and histologically benign tumour of the adolescent male. The aetiology and site of origin are unknown. The diagnosis can easily be made by the symptoms, the typical angiographic pattern and the endoscopic picture. Complete surgical extirpation is superior to all other modalities such as radiotherapy and hormonal treatment. To reduce the enormous blood flow into the tumour, the ligation of the external carotid artery, or the embolisation of the feeding vessels are the best presurgical methods. The technique of tumour removal differs according to the size of the tumour. A great therapeutic problem are those tumours which grow through the skull base and invade the sella, the optic nerve or the cavernous sinus. These tumours should be removed as radically as possible. Small areas of intracranial tumour could remain in order to preserve the optic nerve or the pituitary. These small areas respond very well to 4000 rads. Of 14 patients treated between 1972 and 1981, 12 tumours (types I and II) could be removed completely (recurrence rate 0%), 2 neoplasms ( typ III and IV) which were removed incompletely, received 4000 rads directed at the intracranial remnant, and showed no tumour progression within 4 and 6 years. The preoperative use of hormones (2 cases) showed no effect on the tumour size, especially not on intraoperative loss of blood.