J Korean Assoc Oral Maxillofac Surg 2019; 45(1): 43~47
Nasal septum angiofibroma: a rare condition with an unusual onset
Maria Carla Spinosi1, Francesca D’Amico1, Chiara Mezzedimi1, Cristiana Bellan2, Manuela Cirami2, Ilaria Innocenti Paganelli1
1ENT Clinic, S.M. alle Scotte University Hospital of Siena, 2Institute of Pathologic Anatomy and Histopathology, University of Siena, Siena, Italy
Maria Carla Spinosi
ENT Clinic, S.M. alle Scotte University Hospital of Siena, Viale Bracci 16, 53100 Siena, Italy
TEL: +39-0577-585470 FAX: +39-0577-547940
E-mail: mariacarla.spinosi@gmail.com
ORCID: https://orcid.org/0000-0002-7492-6565
Received August 31, 2017; Revised November 28, 2017; Accepted December 20, 2017.; Published online February 28, 2019.
© The Korean Association of Oral and Maxillofacial Surgeons.. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
The characteristics of extra-nasopharyngeal angiofibromas tend to be different from angiofibromas of the nasopharynx according to patient gender, patient age, prevalence, affected site, pathogenesis, and clinical and epidemiological features. We report a case of an extra-nasopharyngeal angiofibroma in a 28-year-old man referred to the ENT Clinic for right-sided epistaxis, airflow impairment and nasal swelling. The right nostril was completely occluded works by a reddish-yellow mass that bled easily. The computed tomography scan revealed an “inhomogeneous solid lesion in the nasal fossa”. With the patient under general anesthesia, the formation in the anterior portion of the right side of the nasal septum was removed up to its vascular base. Although electrical cauterization efficiently controlled the bleeding, we abraded the sub-perichondral area to prevent further bleeding as well as recurrence. The histological exam report confirmed the diagnosis of angiofibroma. As in our case, epistaxis is commonly the presenting sign of angiofibroma. Yet its onset was peculiar, given that the bleeding started with a low impact trauma. The nasal swelling was also a relevant feature as well as the breathing impairment. Although uncommon, nasal septal angiofibromas should considered in patients with epistaxis.
Keywords: Angiofibroma, Nasal septum, Epistaxis


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