World Articles in Ear Nose and Throat 
Clinical Appearance of Benign Sinonasal Masses
 
ENT USA
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Case 2:  Nasopharyngeal Angiofibroma              Go Back To BSM Manuscript

A 24 year old male presented with complaint of left nasal obstruction with history of profuse epistaxis for 2 years.  CT scan showed classical ‘Holman Miller’ sign of forward bowing of the posterior maxillary wall and was reported as an angiofibroma with extension towards the pterygopalatine fossa. 

The mass was removed by Weber-Ferguson approach.


Figure 1:  Axial CT Scan of Nasopharyngeal Angiofibroma  Click on Pictures to Enlarge

Figure 2:  Axial CT Scan of Nasopharyngeal Angiofibroma  Click on Pictures to Enlarge

The histopathological report showed vascular spaces of varying caliber lined by endothelial cells, devoid of muscle layer separated by loose fibrous tissue and proved the mass to be angiofibroma (see Figure 4).  This case was especially challenging in view of the need for complete removal despite its extension to the sphenoid sinus and poor direct access.


Figure 3:  Surgical Specimen 
Click on Pictures to Enlarge

Figure 4:  Histological Appearance 
Click on Pictures to Enlarge

 

 
 

Figure 5:  Post-Operative View After Removal of Nasopharyngeal Angiofibroma by a Weber-Ferguson Approach.  Click on Pictures to Enlarge

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World Articles in Ear, Nose and Throat  www.waent.org                 Jan 27, 2012              Vol 5-1

Copyright WAENT 2012 All Rights Reserved
 

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