Nasomaxillary Swing — A Novel Approach for Bilateral Angiofibroma

Juvenile nasopharyngeal angiofibroma (JNA) is a histologically benign, highly vascular tumor of the nasopharynx, which commonly presents in male teenagers. Morbidity from JNA is due to progressive obstruction of nasal respiration, bleeding, obstruction, invasion of paranasal sinuses, and in advanced cases due to intracranial extension. Intraorbital extension of tumor can lead to vision loss or ophthalmoplegia.1 Extensive growth is not uncommon because of the silent area of origin. Surgery remains the main treatment modality for this tumor. The choice of a surgical approach is still controversial. The prime aim of any surgical approach is to achieve a good surgical exposure of the tumor so that the complete excision of the tumor can be ensured. Maxillary swing approach is one of the commonly accepted approaches for removal of JNA but it provides exposure to only ipsilateral infratemporal fossa. We here adopted a extended approach called nasomaxillary swing for the large JNA involving bilateral sinuses and infratemporal fossa with intracranial extension.