Juvenile angiofibroma: A more rational therapeutic approach based upon clinical and experimental evidence

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Abstract
A new and more rational therapeutic approach to the diagnosis and management of juvenile angiofibromas was formulated based upon the experiences in 35 cases.Preoperative angiography is essential in delineating the mass, and demonstrating extension into surrounding areas, and for delineation of the sources of blood supply to the tumor. Arteriography has shown 20 percent of the cases to have middle fossa extension, and that the size of the tumor in the nasopharynx does not necessarily represent the size and extent of the tumor and may be only the “tip of the iceberg.”The death of a patient with intracranial extension. The cessation of bleeding, and shrinkage of the tumor was demonstrated by pre and post therapy arteriography and scanning. Because of the success of the transpalatal surgical approach and the hesitancy of administering irradiation too, surgical excision is the treatment of choice in all cases that do not have intracranial extension.