Skull Base Condition (Juvenile Angiofibroma)

What is Juvenile Angiofibroma?

This is a rare tumour almost exclusively seen in males. (If the patient is female consider chromosomal analysis.) It originates from the sphenopalatine foramen and is locally invasive but not malignant. It is a combination of fibrous tissue with endothelial spaces in vascular tissue.

Presentation
->Recurrent epistaxis in young male (average age 14)
->Large posterior nasal mass
->Pulsatile mass palpated prior to adenoidectomy
->Nasal obstruction

Investigations
->Clinical examination with endoscope
->CT scan and MRI
->Angiography
->Do not do a biopsy for fear of life threatening haemorrhage

Management

The treatment is surgical removal, with pre-operative embolisation to reduce the blood loss during the operation. There are several ways to gain accessto the area, but the most common is via the midface in an operation called midfacial degloving.