Diagnostic, therapeutic and anesthetic particularities in the approach of giant vascular sinonasal tumors

Abstract

Vascular tumors of the head and neck are a heterogenous group of conditions that raise numerous problems re­gar­ding diagnosis and optimal therapeutic strategy. He­man­­gio­­mas are benign vascular tumors which are only ex­­cep­­tio­­nally found in the nasal cavity and paranasal si­nuses. His­to­lo­gi­cally, the mixed type is extremely rarely found in the lite­rature. The authors present a series of par­ti­cu­­lar aspects re­gar­ding the approach of such tumors, exem­pli­fying with a case of sinonasal giant hemangioma from the author’s own casuistry. Problems found in the diag­nostic process, difficulties encountered during the treat­ment of large vascular sinonasal tumors, as well as particular elements regarding the succesfull total intra­venous anesthesia are presented. Total intravenous anes­thesia (TIVA) allowed the adequate hemodynamic sta­bi­lity, facilitating a superior intraoperative hemostasis, there­fore leading to the complete endoscopic ablation of the sinonasal hemagioma.