Juvenile Nasopharyngeal Angiofibroma Surgical Approaches

Flashcards summarizing the surgical approaches and treatment strategies for juvenile nasopharyngeal angiofibroma based on the extent of the disease (Table 49.2).

Surgical approach for JNA in the nose and nasopharynx (Location A)

Transpalatal or endoscopic

Surgical approach for JNA in the nose, nasopharynx maxillary antrum and pterygopalatine fossa (Location B)

Lateral rhinotomy with medial maxillectomy OR Endoscopic OR Le Fort I

Surgical approach for JNA involving the nose, nasopharynx, maxillary antrum, pterygopalatine fossa, and infratemporal fossa (Location C)

Extended lateral rhinotomy OR Infratemporal fossa approach OR Maxillary swing approach

Surgical approach for JNA with cheek extension (Location D)

Extended lateral rhinotomy

Treatment approach for JNA with intracranial involvement - Stage B + C + Intracranial (Location E)

Combined intracranial and extracranial approach (craniotomy + one of the extracranial approaches) OR Radiation if intracranial part is inaccessible

Management of extracranial residual or recurrent JNA disease (Location F)

Observation OR repeat surgery or radiation if inaccessible

Treatment for intracranial residual or recurrent JNA (Location G)

Stereotactic radiation (X or gamma knife)