Surgical management of juvenile nasoangiofibroma extending into adjacent structures: a case report
DOI:
https://doi.org/10.18203/2349-2902.isj20252292Keywords:
Juvenile nasoangiofibroma, Endoscopic surgery, Transfacial approach, Skull base, Intraoperative embolization, Maxillectomy, Infratemporal fossa, Skull base surgery, Tumor resection, Multidisciplinary managementAbstract
This case report describes the surgical management of a 16-year-old male diagnosed with a large juvenile nasoangiofibroma extending into the nasal cavity, maxillary sinus, infratemporal fossa, and surrounding structures. The patient presented with a history of progressive facial swelling, nasal obstruction, epistaxis, and left aural fullness. Preoperative imaging, including magnetic resonance imaging (MRI) and angiotomography, demonstrated extensive, highly vascular tumor involvement with critical neurovascular structures. A multidisciplinary surgical approach was employed, combining a Weber-Ferguson transfacial incision with endoscopic sinonasal procedures such as septectomy, turbinectomies, and sphenoidectomy. The operative findings confirmed a large, irregular tumor with attachments to nearby bones and vessels, which was successfully resected with clear margins. Histopathology confirmed juvenile nasoangiofibroma. The postoperative course was favorable, with no complications, and ongoing follow-up was planned to monitor for recurrence. This case highlights the importance of preoperative embolization, tailored surgical strategies, and multidisciplinary collaboration in managing extensive juvenile nasoangiofibromas to achieve optimal outcomes while minimizing morbidity.
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