Nasal angiofibroma is commonly seen in which age group?
Juvenile nasopharyngeal angiofibroma uMC nasopharyngeal benign tumoruTestosterone dependent tumor uMC site of JNA - Sphenopalatine foramen uMC in adolescent boys of 10 - 20 years of age uLocally invasive and vasoformative tumor uClinical features Symptoms Signs oSpontaneous profuse & recurrent epistaxis oProgressive U/L nasal obstruction oHyposmia/AnosmiaoOtalgia, Conducting hearing loss & Serous OM oPink, purplish mass obstructing choanae oSplaying of nasal bones oProptosis & frog face deformity oDiplopia with diminished vision oCN involvement - 2, 3, 4, 5, 6uDiagnosis oIOC of JNA - CECT scan oPathognomonic of JNA - Antral sign or Holmer Miller sign (MRI scan)oCarotid angiography - Shows the tumour extent, vascularity & feeding vessel oBiopsy is contraindicated as it lacks muscular coat uTreatment Surgical RxMinimally invasive Adjunct Rx oTranspalatineoTranspalatine + Sublabial (Sardana approach)oLateral rhinotomy facial incisionoExtended Denker approachoCraniofacial resection approach infratemporal fossaoEndoscopicoTrans maxillary (Le Fo I)oMaxillary swing approachoCarotid angiography with embolization of the feeding vessel, preop stilbestrol, preop radiation therapy and cryotherapyoRadiationoDiethylstilbestrol + Flutamide oChemotherapy with doxorubicin + vincristine + dacarbazine Ref: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no. 228
Adolescent male
Adult male
Elderly male
Elderly female
Nose and paranasal sinuses