OA Journal of Otorhinolaryngology

A Unique Case of Juvenile Nasopharyngeal Angiofibroma (JNA) Involving the Skull Base, Intracranial Cavity, and Para-Pharyngeal Space

Published on: 2019-08-13

Abstract

Juvenile nasopharyngeal angiofibroma (JNA) constitutes 0.05 to 0.5% of all head and neck tumors. This tumor has the propensity to spread from the sphenopalatine fossa to nearby structures such as the intracranial cavity, infratemporal fossa, or much more rarely the para-pharyngeal space. In this case report, we present a 15-year-old male with JNA involving the intracranial cavity, parapharyngeal space, and skull base altogether. Unusually, the patient has had a cranioplasty with a floating anterior skull bone after a repair which made this clinical scenario more challenging. As far as our knowledge, it is the first case of JNA with such extreme involvement to be reported in the literature. A craniofacial approach to the tumor was performed with subsequent peri-cranial flap skull base reconstruction. Since JNA is a highly vascularized tumor with risk for life-threatening hemorrhage, it is necessary to perform a preoperative angiography and embolization in order to reduce operative morbidity. JNA is usually treated with complete surgical excision. Advanced stage JNAs have a tendency to recur. Recurrence is also treated with complete resection and previously other adjacent measures whenever possible.

Keywords

Juvenile Nasopharyngeal Angiofibroma, Otolaryngology, Nasopharyngeal neoplasm, biopsy,head and neck tumors