Background Background: Angiofibroma is a highly vascular tumor of adolescent males located mainly in the nose and nasopharynx. Though benign histologically, it has the potential to spread to adjacent areas of the head and neck and can lead to a variety of Presentations. We studied the management plan of Angiofibroma mainly based on the diagnostic methodology especially CT and MRI scans and treatment modality. Research Methodology: It was a descriptive study of twenty patients of Angiofibroma carried out between Jan. 2002 to Dec. 2003 at the Department of ENT and Head and Neck surgery Khyber Teaching Hospital and PGMI Hayatabad Medical Complex Peshawar. As a main diagnostic methodology computed tomography (CT Scan) was done in all the patients (100%) and magnetic resonance imaging (MRI) in 6 patients (30%) apart from conventional X-Rays of the sinuses and nasopharynx. Treatment modality consisted of various surgical approaches according to the extent of the tumour and Radiotherapy as adjuvant treatment. Regular follow up of the patients was carried out to detect any tumour recurrence. Results Results: All the patients were male (100%) with age ranging from 10-19 years and peak age incidence of 12-16 years (75%) with mean age of 14 years. Recurrent bouts of epistaxis and nasal obstruction were the leading clinical features (100%). Results of the CT and MRI showed involvement of the nose and nasopharynx in 40% and alongwith other sites like maxillary sinus 5%, Pterygopalatine fossa alone 10%, Pterygopalatine Fossa with orbital bone erosion 15%, Infratemporal fossa with cheek, 25% and Intracranial extension 5%. Of the various surgical approaches, transpalatine was the most commonly employed (75%) followed by lateral rhinotomy (45%), medial maxillectomy (30%), Sublabial (25%) and combined extra and intracranial approaches in 5% cases. On the average 2 to 4 pints of blood was used during surgery. No mortality was observed. At regular follow up tumour recurrence was found to be 10%. Radiotherapy used as a primary treatment for intracranial extension in one patient (50%) failed to cure while as adjuvant therapy for recurrent tumours in 2 patients significantly regressed the growth. Conclusion: It is concluded that modern imaging techniques of CT and MR Scans are the most important tools of diagnosis and are of great help in selecting the proper mode of treatment and surgical approaches.
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