An 18-year-old boy presented with repeated epistaxis and there was a mass arising from the lateral wall of his nose extending into the nasopharynx. It was decided that he should be operated. All of the following are true regarding his management except that:
Surgery is the mainstay of treatment in juvenile angiofibroma. The surgical approach is determined by the location of tumour, its extent and surgical expertise. Various approaches used have been as follows:(i) Transpalatal(ii) Transpalatal with sublabial extension(iii) Lateral rhinotomy(iv) La Fort I osteotomy(v) Medial maxillectomy(vi) Maxillotomy(vii) Endoscopic transnasal(viii) Combined intracranial and extracranial approachesIn the present case, the mass is limited to lateral wall of nose and nasopharynx, and transpalatal approach would be the best choice. The other choice would be endoscopic transnasal with pre-operative embolisation. Lateral rhinotomy approach is required when tumour is more extensive, extending into maxillary and ethmoid sinus, pterygomaxillary fossa or even into cheek.
He requires adequate amount of blood to be transfused
A lateral rhinotomy approach may be used
Transpalatal approach is used
Transmaxillary approach is used
Nose and PNS