Juvenile Angiofibroma

Siba P. Dubey, MBBS, MS Siba Dubey obtained his MBBS degree from Calcutta University in 1982. He trained in Otolaryngology - Head and Neck Surgery (ORLHNS) at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. He completed his thesis on "Computed tomography (CT) in Ear diseases - Correlation between CT and surgical findings" and passed Master of Surgery (MS) in ORLHNS in December, 1986. Subsequently, he underwent advanced training in ORLHNS in India and Austria. He came to Papua New Guinea (PNG) in November 1994 to take up the position of Chief Ear, Nose and Throat (ENT) Surgeon. The specialty of ORLHNS grew bigger from one to multiple centres across PNG with the help of locally trained ENT specialists. He became Professor at the School of Medicine and Health Sciences, University of Papua New Guinea in 2002. Since then, he has been involved in the teaching and training of Undergraduate and Postgraduate students of PNG and other Pacific Island countries. He has performed research on clinical and operative aspects, malignancies of head and neck, and tropical diseases, namely, angiofibroma, scleroma etc. These works are published in international journals and in books. Bernhard Schick, MD After studying medicine at the Philipps-University in Marburg, Germany from 1987 to 1993 he completed his doctor thesis in 1993. Entitled "Enzymatic analysis of myosin-subfragment-1 induced actin polymerisation" the thesis was honoured by the note "summa cum laude". ENT specialization took place under the supervision of Prof. Dr. Dr. W. Draf (Fulda-Hospital, Germany) from 1994 ton 1998. Specialization for plastic head and neck surgery was successfully achieved under the supervision of Prof. Dr. Dr. W. Draf (Fulda Hospital, Germany) from 1998 to 2000. As the representative of the Head at the ENT-Department at the Saarland University (Prof. Dr. P.K. Plinkert) from 2000 to 2003 habilitation was successfully finished in 2003, presenting new findings of inner ear mechanics analysing VASP expression in the inner ear with the chance to analyse hearing in VASP-/- mice by detailed electrophysiological examinations. He has been Head of the ENT-Department at the Saarland University since June 2008, and is now Medical Director of Uniklinikum Saarland and CEO. During a 20 year period extensive studies have been performed on juvenile angiofibromas, from genetic and molecular studies to clinical evaluations including radiological tumor presentation, surgical strategies and development of an etiological model describing tumor genesis.

Part I History, Anatomy and Tumor Biology.- Historical Background.- Surgical Anatomy of the Skull Base.- Pathologic and Electron Microscopic Features.- Recent Concept of Etiology.- Part II Clinical and Radiological Diagnosis.- Clinical Presentation.- Juvenile Angiofibroma and the Eye .- Radiological Diagnosis.- Staging Systems and their Use.- Part III Management.- Pre- and Intraoperative Embolization.- Anesthesia and Management of Intraoperative Bleeding.- Endoscopic Surgery.- Endoscopic Excision of Advanced with Skull Base Involvement.- Excision by Midfacial Degloving Approach.- Excision by Modified Transpalatal and Maxillary Swing Approach Excision by Le Fort I Osteotomy Approach.- Excision by Lateral Skull Base Approach.- Combined Neurosurgical and Craniofacial Approach for Large Intracranial Tumor.- Radiation Therapy.- Adjuvant Chemotherapy and Hormonal Therapy.- Part IV Other Issues.- Recurrence of Tumor - Its Prevention and Management.- Extranasopharyngeal Angiofibroma.- Remaining Controversies in Nasopharyngeal Angiofibroma.