Facial Translocation Approach for Nasopharyngeal Angiofibroma / 대한이비인후과학회지

Angiofibroma is a benign tumor that predominantly affects male adolescent and the most common benign tumor of nasopharynx. These tumors are highly vascular and usually with extension to the nose, paranasal sinus, pterygomaxillary fossa, infratemporal fossa, cranium, and the neck. There are many therapeutic approaches to huge sized angiofibroma with intracranial extension. Recently we experienced two cases of nasopharyngeal angiofibroma invading cranial base that was resected by facial translocation approach after superselective embolization and direct intratumoral embolization with good results. So, we report these with the review of literature.

Anterior Approaches to Midline Skull Base Tumors

Among various approaches to midline skull base tumors, anterior approaches can provide excellent visualization of the lesion. Since June 1989, 12 anterior procedures have been carried out on 9 consecutive patients presenting with midline skull base tumors(four transsphenodal approches, three Le Fort I osteotomies. Two lateral rhinotomies, two facial translocation approaches, and one craniofacial approach). These anterior procedures allowed good access to the lesions. Wound healing was rapid, with little discomfort to the patients. Cosmetic results were also excellent, and there were no significant problems related to malocclusion in the cases of Le Fort I osteotomy. Patients who underwent facial translocation approach developed nasolacrimal duct obstruction and small area hypesthesia on the cheek. Postoperatively, two patients died from tumor progression and meningitis secondary to CSF leakage, respectively. Although the number of cases and follow-up period are limited in our series, we think that anterior approaches may be useful in the surgical treatment to midline skull base tumors.