Combined intracranial and extracranial excision of nasopharyngeal angiofibroma.

Of all angiofibromas, 10% to 20% may have intracranial extensions or receive vascular supply from the internal carotid artery. Until recently, the treatment of intracranial involvement has been radiation therapy. However, with improved anesthetic and neurosurgical techniques, transfusion capabilities and embolotherapy, the combined intracranial and extracranial excision of an angiofibroma has resulted in a low morbidity and mortality and a greater chance for complete excision of the tumor. The authors present the management of three patients with intracranial involvement of their tumors. Use of the midfacial degloving approach to the nasal cavity and paranasal sinuses has resulted in a significant improvement in the cosmetic appearance postoperatively.