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Otolaryngol Clin North Am. 2016 Jun;49(3):791-807. doi: 10.1016/j.otc.2016.02.009.

Endoscopic Management of Vascular Sinonasal Tumors, Including Angiofibroma.

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Department of Otolaryngology, Center for Cranial Base Surgery, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, 200 Lothrop Street, EEI Suite 500, Pittsburgh, PA 15213, USA. Electronic address:
Department of Otolaryngology, Head and Neck Surgery, University of Adelaide School of Medicine, Eleanor Harrald Building, Frome Road, Adelaide, South Australia 5005, Australia.


The greatest challenge in the surgical treatment of angiofibromas is dealing with the hypervascularity of these tumors. Staging systems that take into account the vascularity of the tumor may be more prognostic. A variety of treatment strategies are used to deal with the vascularity of angiofibromas, including preoperative embolization, segmentation of the tumor into vascular territories, use of hemostatic tools, and staging of surgery. Even large angiofibromas with intracranial extension and residual vascularity can be successfully managed by a skull base team using endoscopic techniques.


Angiofibroma; Coblation; Embolization; Harmonic scalpel; Internal carotid artery; Juvenile nasopharyngeal angiofibroma; Staging system; Vascularity

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