Juvenile angiofibroma protruding from the nasal cavity

@#OBJECTIVE/strong: To describe a case of juvenile angiofibroma with unusual protrusion out of the nasal cavity, and its management with surgery and radiotherapy.br /br /strongMETHODS:/strong br /strongDesign/strong: Case Report br /strongSetting/strong: Tertiary Public Referral Centre br /strongPatient/strong: Onebr /br /strongRESULTS/strong: A 17-year-old gentleman presented with a huge tumor protruding from his left nostril, diagnosed with juvenile angiofibroma stage IlIA by MRI and angiography. Following successful pre-operative embolization, the protruding mass was ligated and truncated, followed by surgical resection via external approach. Post-operative residual tumor was treated with adjuvant radiotherapy. There was no evidence of recurrence after nine months.br /br /strongCONCLUSION/strong: A high index of suspicion is of paramount importance in the diagnosis of JA and avoids the possibility of an unwarranted biopsy which could spell disaster. The most useful tools for diagnosis are MRI and arterial angiography. Treatment is primarily surgical. Irradiation therapy has been reported to achieve satisfactory outcomes, especially for unresectable residual disease and/or intracranial extension, where total surgical resection is unlikely to be attained without unacceptable morbidity./p

The lower cheek flap combined with neurosurgical approach for infratemporal fossa tumour

p style=text-align: justify;strongOBJECTIVE:/strong To describe our experience in performing the lower cheek flap for access to the infratemporal fossa combined with the neurosurgical approach. br /br /strongMETHODS:/strongbr /strongDesign:/strong Case report br /strongSetting:/strong Tertiary Referral Center br /strongPatients:/strong Two br /br /strongRESULTS:/strong Two unusual tumours involving the infratemporal and middle cranial fossa were excised using this combined appoach. The infratemporal fossa tumour was accessed via the lower cheek flap while the intracranial portion was resected from above via craniotomy.br /br /strongCONCLUSION:/strong The lower cheek flap in combination with the neurosurgical approach allows optimal exposure to tumours involving the infratemporal and middle cranial fossae. It has less complications and better aesthetic outcome compared to other approaches./p