Juvenile nasopharyngeal angiofibroma: report of a case using the Le Fort I approach

Abstract

Juvenile nasopharyngeal angiofibroma is a rare and highly vascularized benign neoplasm. It represents 0.05% to 0.5% of head and neck neoplasms. In more advanced stages, it presents intracranial involvement with facial deformity and ocular proptosis. Histopathologically, they are non-encapsulated and well-circumscribed polypoid masses formed by vascular and fibrous stromal tissue. Evaluation is based on diagnostic imaging, mainly with computed tomography (CT) or magnetic resonance imaging (MRI). The Le Fort I osteotomy approach has been used for the treatment of midface deformities. This procedure has the advantage of offering excellent exposure of difficult-to-access sites, it does not generate facial scars, and pre-surgical biopsy is not recommended. The prognosis is good. The objective of this article is to present the case of a patient diagnosed with juvenile nasofibroangioma, according to the Radkowski classification system, corresponding to III according to Chandler and II according to Fish. A Le Fort I approach is performed, the tumor is resected and osteosynthesis is performed with titanium plates and screws to restore the patient's dental occlusion. Go for periodic check-ups to verify the absence of mass in the nasal passages.