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Importance of Pre–operative Emobilisation in the Surgery of Nasopharyngeal Angiofibroma
Juvenile Nasopharyngeal Angiofibroma are rare vasoformative neoplasms of the Nasopharynx. Due to the innocuous nature of their presenting symptoms, the tumor frequently has extra nasopharyngeal extensions at the time of initial diagnosis. The advances in radiographic CT techniques and pre–operative emobilization have reduced the mortality and morbidity to a great extent. We analyzed nine cases of angiofibroma with and without emobilization and concluded that preoperative emobilization reduces intra operative blood loss considerably, giving excellent surgical clearance of the tumor mass with minimal risk of recurrence.

Materials and methods
Nine cases of proved nasopharyngeal angiofibroma after clinical evaluation, imaging and angiography, were subjected for the surgical resection. First 14 cases of Stage I and II were approached by the Tran palatal route and whole tumor mass with pedicle attached at the nasapharynx was excised. These cases which did not undergo emobilization and the total blood loss of 10–12 units was quite significant intra–operatively.(because of unavailability of embolization facilities)

The second group of 24 cases of stage II B and C were subjected for surgical clearance by lateral rhinotomy and Tran–palatal approach. The whole mass could be removed. The preoperative emobilization reduced intra–operative blood loss considerably,and required only two units of blood. The post–operative recovery was uneventful. The third group of another 12 cases of Stage III (a) was approached by lateral rhinotomy and Medical Maxillectomy. The preoperative emobilization reduced intra–operative blood loss significantly requiring only one unit of blood giving precise surgical excision in the tumor mass clearance. All cases treated at this hospital did not show any recurrence so far.

Read more: Surgery of Nasopharyngeal Angiofibroma