Objective: Nasopharyngeal angiofibroma better method of minimally invasive surgery. Methods: 4 cases of nasopharyngeal angiofibroma using endoscopic techniques supplemented by arterial embolism, anesthesia and controlled hypotension by means of semiconductor laser therapy lessons. Results: 1 case of bleeding 3 000ml, residual tumor, further into the way the hard palate and root of nasopharyngeal angiofibroma excision. The other 3 patients were cured, the blood loss 100 ~ 500ml, no postoperative complications, up from 4 to 31 months without recurrence. Conclusion: The endoscopic treatment of nasopharyngeal angiofibroma is a better method of minimally invasive surgery. It should be noted the choice of indications, adequate preoperative preparation and intraoperative certain operating skills Key to successful operation.

Key words: nasopharyngeal carcinoma, angiofibroma, endoscopy, minimally invasive surgery

Nasopharyngeal angiofibroma is a rare benign tumor occurs in adolescent males, tumor blood vessel-rich, easy bleeding, also known as "male puberty bleeding nasopharyngeal angiofibroma." Disease of unknown cause, because of primary base of the skull, part of deep, strong expansion of tumor growth, bleeding fierce, sinister clinical manifestations. Treatment based on surgery, surgery is difficult, prone to complications. I Division Endoscopic Resection of nasopharyngeal angiofibroma in 4 cases, reported as follows:

1.       clinical data

Case 1 Male, 21 years old, progressive left nasal obstruction, with recurrent left nasal bleeding for 3 years. Examination: the left posterior nasal cavity, nasopharynx shows a 4cm × 3cm × 2cm size of the tumor, blocking the left posterior nostril, wide base, smooth, vascular expansion. CT and MRI are reported nasopharyngeal angiofibroma, some invading the sphenoid sinus inferior wall, sphenopalatine foramen and pterygopalatine fossa. Carotid angiography (DSA) examination showed nasopharyngeal angiofibroma, left maxillary artery with gelatin sponge particles were abandoned, 2 days after successful embolization under general anesthesia under controlled hypotension down Endoscopic resection of nasopharyngeal angiofibroma intraoperative view of left nasal cavity, nasopharynx tumor, wide base, with the inferior turbinate, lateral nasal, outer wall of the nasopharynx, nasal cavity and the rear end wall, nasal septum or inferior border of adhesion, smooth surface, there is expansion of blood vessel patterns . Application of semiconductor laser resection of inferior turbinate posterior, and in the mass in front of 0. 5cm Department periosteum incision, bleeding edge cutting edge, back strip, separating the base mass, completely separated, it will pull from the nasal cavity tumor complete out. Check the full mass, including the sphenopalatine foramen, part of the pterygopalatine fossa complete removal. Cutting suction to the mucosa surrounding the tumor resection, laser to stop bleeding, packing operative cavity, blood loss 100ml, operation time of about 1h, 4d after pulling stuffing, discharged the next day. Pathology: Nasopharyngeal angiofibroma. 2-year follow-up, no local recurrence.

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