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Juvenile angiofibroma: the lessons of 20 years of modern imaging

Published online by Cambridge University Press:  29 June 2007

Glyn Lloyd ,
David Howard ,
Peter Phelps  and
Anthony Cheesman
Glyn Lloyd*
Affiliation:
The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK.
David Howard
Affiliation:
The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK.
Peter Phelps
Affiliation:
The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK.
Anthony Cheesman
Affiliation:
The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK.
*
Address for correspondence: Dr Glyn Lloyd, 107 Harley Street, London W1N 7DG.
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Abstract

Seventy-two patients with juvenile angiofibroma have been investigated by computerized tomography (CT) and/or magnetic resonance imaging (MRI) over a period of 20 years. The evidence from these studies indicates that angiofibroma takes origin in the pterygo-palatine fossa at the aperture of the pterygoid (vidian) canal. An important extension of the tumour is posteriorly along the pterygoid canal with invasion of the cancellous bone of the pterygoid base, and greater wing of the sphenoid (60 per cent of patients). Distinctive features of angiofibroma are the high recurrence rate, and the rapidity with which many tumours recur. It is postulated that the principle determinant of recurrence is a high tumour growth rate at the time of surgery coupled with incomplete surgical excision. The inability to remove the tumour in toto is principally due to deep invasion of the sphenoid, as described above. In this series 93 per cent of recurrences occurred withthis type of tumour extension. A contributory cause in these patients is the use of pre-operative embolization. The treatment implications of these findings are examined.

Keywords

AngiofibromaTomography scanners, X-ray computedMagnetic resonance imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 2 , February 1999 , pp. 127 - 134
Copyright
Copyright © JLO (1984) Limited 1999

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References

Acuna, R. T. (1956) The nasopharyngeal fibroma and its treatment. Archives of Otolaryngology 64: 451–455.CrossRefGoogle Scholar
Casson, P. R., Bonnano, P. C., Converse, J. M. (1974) The mid-face degloving procedure. Plastic and Reconstructive Journal 53: 102–113.CrossRefGoogle Scholar
Chelius, M. J. (1847) A System of Surgery. Vol 2, Renshaw, London, p 726.Google Scholar
Chauveau, C. (1906) Histoire des Maladies du Pharynx. J.B. Ballière et Fils, Paris p562.Google Scholar
Cummings, B. J., Blend, R., Keane, T. (1984)Primary radiation therapy for juvenile nasopharyngeal angiofibroma. Laryngoscope 94: 1599–1605.CrossRefGoogle ScholarPubMed
Economou, T. S., Abemayor, E., Ward, P. H. (1988) Juvenile nasopharyngeal angiofibroma. An update on the UCLA experience, 1960–1968. Laryngoscope 98: 170–175.CrossRefGoogle Scholar
Friedberg, S. A. (1940) Nasopharyngeal fibroma. Archives of Otolaryngology 31: 313–326.CrossRefGoogle Scholar
Gosselin, L. (1873) Fibrome ou polype fibreux nasophayngien. Clinique Chirugicable De Hôpital de la Charite (Paris) 1: 92–116.Google Scholar
Gullane, P. J., Davidson, J., O'Dwyer, T., Forte, V. (1992) Juvenile angiofibroma: a review of the literature and a case series report. Laryngoscope 102: 928–933.CrossRefGoogle Scholar
Harma, R. A. (1959) Nasopharyngeal angiofibroma. Acta Otolaryngologica (Suppl 146): 7–74.Google ScholarPubMed
Holman, C. B., Miller, W. E. (1965) Juvenile nasopharyngeal angiofibroma. American Journal of Roentgenology 94: 292–298.Google Scholar
Hora, J. F., Weller, W. A. (1961) Extranasopharyngeal juvenile angiofibroma. Annals of Otology Rhinology and Laryngology 70: 164–170.CrossRefGoogle ScholarPubMed
Howard, D. J., Lund, V. J. (1992) The midfacial degloving approach to sinonasal disease. Journal of Laryngology and Otology 106: 1059–1062.CrossRefGoogle ScholarPubMed
Laffargue, B. (1947) Considerations sur les fibrose naopharyngiens étude anatomico-clinique. Revue de Laryngologie 68: 436–465; 514–539.Google Scholar
Liston, R. (1841) University College Hospital. Tumour of the upper jaw bone: Excision and recovery. Lancet 1: 67–68.Google Scholar
Lloyd, G. A. S., Barker, P. B. (1991) Subtraction magnetic resonance for tumours of the skull base and sinuses: a new imaging technique. Journal of Laryngology and Otology 105: 628–631.CrossRefGoogle ScholarPubMed
McCombe, A., Lund, V. J., Howard, D. J. (1990) Recurrence in juvenile angiofibroma. Rhinology 28: 1–6.Google ScholarPubMed
Myhre, M., Michaels, L. (1987) Nasopharyngeal angiofibroma treated in 1841 by maxillectomy. Journal of Otolaryngology 16: 390–392.Google ScholarPubMed
Stansbie, J. M., Phelps, P. D. (1986) Involution of residual angiofibroma. Journal of Laryngology and Otology 100: 599–603.CrossRefGoogle ScholarPubMed
Weprin, L. S., Siemers, P. T. (1991) Spontaneous regression of juvenile nasopharyngeal angiofibroma. Archives of Otolaryngology – Head and Neck Surgery 117: 796–799.CrossRefGoogle ScholarPubMed