Journal of Clinical Otolaryngology Head and Neck Surgery
The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery

유년성 혈관섬유종의 임상적 분석

노환중1, 고의경1, 왕수건1, 전경명1, 이상민2
Hwan-Jung Roh1, Eui-Kyung Goh1, Soo-Geun Wang1, Kyong-Myong Chon1, Sang-Min Lee2
1부산대학교 의과대학 이비인후과학교실
1Department of Otolaryngology, College of Medicine, Pusan National University
2St. Benedict Hospital

© Copyright 1998 The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: May 31, 2020


Juvenile angiofibroma is a rare head and neck tumor which is characterized by high vascularity, predominance in adolescence, aggressive growth with surrounding tissue destruction, and high recurrence. We retrospectively reviewed 22 cases of juvenile angiofibromas operated at Pusan National University Hospital from January 1982 to October 1997 to analyze the clinical behavior, effect of preoperative embolization, indication of different surgical approach according to Sesson's tumor staging, operative findings, and results of postoperative follow-up to help for establishing treatment modalities of angiofibroma. Frequent epistaxis and nasal obstruction were most common symptoms. Most angiofibromas originated from posterior-superior-lateral wall of nasal cavity, attaching to posterior wall of nasopharynx and posterior nasal septum. Sphenoid sinus and pterygomaxillary fossa were common extension sites. The main feeding vessels were branches of ipsilateral internal maxillary artery, especially sphenopalatine artery as terminal branch. In Sesson's stage I transpalatal, transnasal, endonasal endoscopic, Denker's, lateral rhinotomy approach were applied in order. In stage II lateral rhinotomy, endonasal endoscopic, transpalatal, maxillary swing approach applied. Recurrence was each 1 case of IB and IIA (9.0%). Preoperative embolization did not reduce intraoperative blood loss. However, endonasal endoscopic surgery reduced bleeding amount significantly, suggesting that much of blood loss occurred from bone and adjacent structure during extranasal surgical approach. Our results of endonasal endoscopic removal suggest that stage IA, IB, IIA are good indications for endoscopic surgery and can be further extended to stage IIB.

Keywords: Juvenile angiofibroma; Endoscopic surgery; Rhinosinus tumor