Tailoring the Optimal Surgical Strategy for the Endoscopic Removal of Juvenile Nasopharyngeal Angiofibromas

Being centered around the sphenopalatine foramen, juvenile nasopharyngeal angiofibromas are notorious for growing toward the infratemporal fossa via the pterygomaxillary fissure. Since, this tumor grows from 'within' the sinonasal space, it would be best to surgically follow it from the same path that it took to grow. With the development of endoscopic techniques and instrumentation, endoscopic approaches to the infratemporal fossa have been universally accepted. Nevertheless, since the tumor does not follow a definitive pattern, each surgery needs to be tailored. In the authors' experience, a preoperative radiological assessment can prove to be a relatively valuable guide to estimate and plan the surgical trajectory that need be taken for this particular tumor.