Endoscopic management of juvenile nasopharyngeal angiofibromas

The origin of juvenile angiofibroma is usually around the region of the sphenopalatine artery, and the surgical management of large tumors can be challenging. Traditional approaches to advanced tumors involved open transfacial or transcranial microscope-assisted surgery. Advances in image guidance and endonasal endoscopic techniques have made endonasal endoscopic approaches to the pterygopalatine and infratemporal possible. Endoscopes allow for greater magnification and visualization of complex anatomy, and endoscopic approaches allow the surgeon to avoid manipulation of the osseous midfacial structures that may result in craniofacial abnormalities in this adolescent population.