Angiofibroma: treatment trends in 150 patients during 40 years.

A series of 150 patients with histologically confirmed angiofibroma examined from 1945 through 1983 was studied to contrast treatment methods and surgical approaches. From 1945 to 1955, treatment consisted primarily of radiation. From 1955 through 1971, the primary method of treatment was surgical removal; the lateral rhinotomy approach was used to expose the tumor and its extensions in most cases. From 1971 through 1983, all tumors were removed surgically. Trends in diagnosis, treatment, and adjunctive therapy at a single institution were evaluated. Specifically, the trends considered were operative approaches, blood replacement with and without hypotensive anesthesia, adjunctive measures such as hormonal therapy or tumor embolization, mortality, and morbidity. Lateral rhinotomy provides wide exposure of and access to the nose, nasopharynx, paranasal sinuses, elements of the skull base, temporal fossa, and infratemporal fossa. Surgical treatment, specifically the lateral rhinotomy approach and its extensions, is recommended as the best method of managing angiofibroma in most patients.