Juvenile nasopharyngeal angiofibroma with intracranial extension: analysis of 23 Egyptian patients.

The purpose of this study was to present our experience with definitive surgical management of patients with Juvenile nasopharyngeal angiofibroma with intracranial extension. The study included 23 male adolescents with histologically proven juvenile nasopharyngeal angiofibroma. The mean age was 14.7 years (12-20 years). CT, MRI+/-angiographies were for taken for the patients. Preoperative embolization was done with gel foam before the operation. Two surgical procedures were used; anterior subcranial transfacial transmaxillary approach (21 patients), while craniofacial resection was used in two patients. Middle cranial fossa was affected in 22 patients while anterior cranial fossa was affected in only one patient. Complete resection of the tumor was achieved in 19 patients with residual or recurrence in four patients. Complications of the surgical approaches were reported in 14 patients. The subcranial transfacial transmaxillary approach avoids the complications of craniotomy and provides adequate access for excision of Juvenile nasopharyngeal angiofibroma with intracranial extradural extension.