Endoscopic Management of Vascular Sinonasal Tumors, Including Angiofibroma

Otolaryngol Clin North Am. 2016 Jun;49(3):791-807. doi: 10.1016/j.otc.2016.02.009.

Abstract

The greatest challenge in the surgical treatment of angiofibromas is dealing with the hypervascularity of these tumors. Staging systems that take into account the vascularity of the tumor may be more prognostic. A variety of treatment strategies are used to deal with the vascularity of angiofibromas, including preoperative embolization, segmentation of the tumor into vascular territories, use of hemostatic tools, and staging of surgery. Even large angiofibromas with intracranial extension and residual vascularity can be successfully managed by a skull base team using endoscopic techniques.

Keywords: Angiofibroma; Coblation; Embolization; Harmonic scalpel; Internal carotid artery; Juvenile nasopharyngeal angiofibroma; Staging system; Vascularity.

Publication types

  • Review

MeSH terms

  • Angiofibroma* / blood supply
  • Angiofibroma* / pathology
  • Angiofibroma* / surgery
  • Disease Management
  • Embolization, Therapeutic* / instrumentation
  • Embolization, Therapeutic* / methods
  • Hemostasis, Surgical* / instrumentation
  • Hemostasis, Surgical* / methods
  • Humans
  • Intraoperative Complications / etiology
  • Intraoperative Complications / prevention & control*
  • Nasopharyngeal Neoplasms* / blood supply
  • Nasopharyngeal Neoplasms* / pathology
  • Nasopharyngeal Neoplasms* / surgery
  • Neoplasm Staging
  • Preoperative Care / methods
  • Surgical Procedures, Operative* / adverse effects
  • Surgical Procedures, Operative* / methods
  • Vascular System Injuries / etiology
  • Vascular System Injuries / prevention & control*