Abstract
Five cases of multiple extrapharyngeal extension of nasopharyngeal fibroma seen during the last 8 years were operated by a combined transzygomatic and transpalatal/or per via naturalis approach. The transzygomatic approach is excellent for exposing the lateral extension of this tumour and for efficient control of bleeding under direct vision. Salient features of its clinical behaviour, operative findings and pitfalls in the management are described.

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