Abstract

Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascularized, locally aggressive benign tumor, occurring almost exclusively in young men. The tumor is assumed to originate in the sphenopalatine foramen area. Tumor invasion to the nasal cavity, paranasal sinuses, orbit, pterygomaxillary fossa, infratemporal fossa, cheek, cavernous sinus, and anterior or middle cranial fossa may occur. Blood supply to the tumor most commonly arises from the internal maxillary artery. A variety of surgical techniques to the facial skeleton and the skull base are now well established; this is mainly the result of improved preoperative imaging assessment, technical advances in tumor resection and reconstruction, improved postoperative care, and the cooperation of multidisciplinary teams. In children and adolescents with JNA, we have used the combined midfacial degloving/transmaxillary approach and the facial translocation technique. The preoperative evaluation, surgical technique, advantages, and limitations of these approaches will be detailed.

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