鼻咽血管纤维瘤向前扩展可至鼻腔和筛房,向外侧经蝶腭孔进入翼腭窝,由此再向上过眶下裂,越眶尖或经眶上裂连颅中窝。本病手术进路有经腭、经筛窦、鼻侧切开及颌后间隙进路等。本文介绍当肿瘤侵犯翼腭窝时可单纯采用经上颌窦进路或结合其他进路,此径路可暴露肿瘤,结扎颌内动脉,并可轻易地经眶下裂剥出肿瘤。手术方法:在唇下从中线作一延长切口,向外连上颌结节,切开上颌骨骨膜,向上分离至眶下孔,上颌前壁用骨钳咬除,然后广泛切除窦腔后壁,直到能暴露翼腭窝肿瘤为止,可能时在切除肿瘤前结扎颌内动脉。若要进入鼻腔及鼻咽部,应除去窦腔内壁,肿瘤侵犯筛窦,应从上颌窦内打开筛房,并仔细剥离;若肿瘤进入更外侧 Nasopharyngeal vascular fibroids can be extended to the nasal cavity and the screen room to the outside of the transsphenoidal hole into the pterygopalatine fossa, which then up through the infraorbital fissure, the more orbital apex or supraorbital fissure with cranial fossa. The surgical approach to the disease through the palate, the ethmoid sinus, nasal incision and jaw space approach. This article describes the tumor invasion of the pterygopalatine fossa can be simply adopted by the maxillary sinus approach or combined with other access, this path can expose the tumor, ligation of the mandibular artery, and can easily stripped the tumor through the infraorbital fissure. Surgical methods: under the lip for an extension of the incision from the midline, external maxillary tuberosity, incision of the maxillary periosteum, upward separation to the infraorbital foramen, maxillary anterior wall with bone forceps bite, and then extensive resection of the posterior wall of the sinus, Until the pterygopalatine tumor can be exposed, it is possible to ligate the internal carotid artery before tumor resection. To enter the nasal cavity and nasopharynx, should remove the inner wall of the sinus cavity, the tumor invading the ethmoid sinus should be opened from the maxillary sinus and carefully dissected; if the tumor into the more lateral