Nasal angiofibroma of nose is common in: March 2011
Ans. A: Young Males Nasopharyngeal fibroma/ juvenile nasopharyngeal angiofibroma is seen almost exclusively in males in the age group of 10-20 years Nasopharyngeal angiofibroma (also called juvenile nasopharyngeal angiofibroma) It is a histologically benign but locally aggressive vascular tumor that grows in the back of the nasal cavity. It most commonly affects adolescent males. Patients with nasopharyngeal angiofibroma usually present with one-sided nasal obstruction and recurrent bleeding. Frequent chronic epistaxis (Nose-Bleeds) or blood-tinged nasal discharge Nasal obstruction and rhinorrhea Conductive hearing loss from eustachian-tube obstruction Diplopia, which occurs secondary to erosion into the cranial cavity and pressure on the optic chiasma If nasopharyngeal angiofibroma is suspected based on physical exam (a smooth submucosal mass in the posterior nasal cavity), imaging studies such as CT or MRI should be performed. Biopsy can lead to extensive bleeding since the tumor is composed of blood vessels without a muscular coat. Differential diagnosis Antro-choanal polyp (benign neoplasm) Rhinosporidiosis (as bleeding point is here too) Malignancy - nasopharyngeal carcinoma, lymphoma, plasmacytoma, rhabdomyosarcoma Chordoma Nasopharyngeal cyst Pyogenic granuloma Treatment Medical treatment is usually given before surgery to reduce the blood loss - includes the usage of Diethylstilbestrol 2-3 weeks before surgery to make the surgery less vascular. Nasopharyngeal angiofibroma is sometimes treated by surgery. Pre-surgery angiography may allow for embolization, reducing intraoperative blood loss. Hypotensive Anaesthesia is the usual modality followed to reduce blood loss. Patients with tumors that have extended into the cranial cavity or whose tumors can't be safely reached by surgery may receive radiation therapy. Also Radiation therapy helps in case where recurrence is the main problem. Endoscopy has recently been used in patients with tumors of limited extension that have been pre-operatively embolized.
Younger males
Younger females
Young adults
Adolescents of both sexes