Imaging and management of angiofibroma.

Five cases of juvenile angiofibroma are reported. The nose and nasopharynx were involved in four cases and the nose and right maxillary sinus in one. Presenting symptoms were epistaxis and nasal blockage while two patients also had dacryocystitis and secretory otitis media. All patients had CT scans done and magnetic resonance imaging was required for two patients. Angiography with embolization of both internal maxillary arteries was performed in all patients. Biopsies were taken in three patients but no blood transfusion was needed. Tumor resection were then done, using a transpalatal approach in four cases. Ligation of the external carotid artery was carried out in one patient who had tumor recurrence with disappearance of the remaining part of the tumor occurring 6 months after the ligation. Although no conclusions can be reached from one case, a question can be raised as to whether this method should be used.