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Angiofibroma

Angiofibroma, specifically nasopharyngeal angiofibroma, is a benign and highly vascular tumor primarily affecting adolescent males, originating in the posterior nasal cavity. Symptoms include nasal obstruction, epistaxis, and headaches, while investigations often involve imaging techniques like CT and MRI. Treatment typically involves surgical intervention, with radiotherapy and hormone therapy reserved for specific cases.

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Dua Ali
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25 views18 pages

Angiofibroma

Angiofibroma, specifically nasopharyngeal angiofibroma, is a benign and highly vascular tumor primarily affecting adolescent males, originating in the posterior nasal cavity. Symptoms include nasal obstruction, epistaxis, and headaches, while investigations often involve imaging techniques like CT and MRI. Treatment typically involves surgical intervention, with radiotherapy and hormone therapy reserved for specific cases.

Uploaded by

Dua Ali
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

ANGIOFIBROMA

roll no : 25
Dhan khatri
Points we have to discuss
• what is angiofibroma?
• Its usually cause and site of origin
• Its extensions and symptoms

• Its signs and investigation


• Differential diagnosis
• Treatment
AngiofibromA
(nasopharyngeal angiofibroma)

• so, as name implies angiofibroma is made up of vascular and


connective tissue

• Uncommon, benign and extremely vascular tumour

• Mainly occurs in second decade of life (adolescent age)


Aetiology
• Harmartomatous nidus
testosterone

angiofibroma

• Fibroblastic: abN growth of connective tissue


site of origin

• Posterior part of the


nasal cavity close to the
superior margin of
sphenopalatine foramen.
Spread
Anterior growth

• Nasal cavity (filled on one side, septum deviates to the other side),
maxillary sinus

Superior growth
• Sphenoid sinus, cavernous sinus, pituitary fossa, optic chaisma, middle
cranial fossa
Lateral spread
• Pterygopalatine fossa → Pterygomaxillary fissure
→ infratemporal fossa → Cheek
• Greater wing of the sphenoid → middle fossa/ dura
Infraorbital fissures
Orbit (Proptosis ,optic
nerve atrophy )

Posterior
• Nasopharynx
Symptoms
• Nasal obstruction (most frequently)
• Epistaxis
• headache
• unilateral rhinorhea
• anosomia/hyposomia
Signs
• Nasal /Nasopharyngeal mass (80%)
• Orbital mass (15%) , Proptosis (10 -15%)

• Cheek swelling and trismus


• Frog face deformity

• Serous otitis media (ET blockage)


• Cranial nerve involvement (I, III, IV, V VI)
Characteristic Presentation : Teenage or young adult male with
recurrent epistaxis, nasal mass and nasal obstruction
Differential diagnosis
Other causes of nasal obstruction
• Nasal polyp ( not seen in young children)
• dermoids ( congenital)
• Squamous cell carcinoma ( smoking history +ve)
• inverted papilloma (30 to 40 old)

Others causes of bleeding


• local = septal hemagioma
• systemic= factor viii deficiency , vwB
Investigation
Plain x-ray of lateral view

CT scan of nose and PNS (CECT)


• Main sign known as holman
miller sign
• Anterior bowing of posterior
maxillary wall
Magnetic resonance imaging (MRI)

• Delineate and define the soft tissue extent in


cases of intracranial involvement.
Angiography
• It is perfomed to see the
feeding vessel of angiofibroma,
which can be helpful in
embolisation preoperatively
• most commonly is internal
carotid artery

Biopsy
• Contraindicated
Treatment Options
Surgery
• Gold standard

Radiotherapy
• Reserved for unresectable
• tumor, intracranial
• extension, recurrent cases

• Chemotherapy
• Hormone therapy
surgical approaches
• transpalatine approach

• transpalatine+sublabial
approach ( sardana
approach) • extended lateral rhinotomy
1. via facial incision
2. degloving approach

• Extended denker approach

• infratemporal approach
Thank
You!

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