Juvenile angiofibroma

  • Adolescent boys
  • Heavy epistaxis
  • Benign, locally invasive
  • Mass originates at sphenopalatine foramen, widens the pterygopalatine foramen, extends into nasal cavity, erodes medial pterygoid plate and skull base near Vidian canal. 
  • Contrast enhanced MR preferred over CT
  • Preoperative embolism helps to reduce blood loss