Abstract
Craniofacial approaches may still be necessary, especially in those cases with significant intracranial tumor burden, those with intimate tumor association with the internal carotid artery (ICA), and those where the tumor has a significant extension laterally to the carotid artery. Complications including cerebrospinal fluid (CSF) leakage may necessitate reoperation or cerebrospinal fluid diversion. Meticulous closure using vascularized flaps minimizes the incidence of such complications. Given the proximity of the pathology to the intracranial circulation, the surgical team must be prepared for and able to perform standard revascularization procedures in the setting of inadvertent injury to these vessels. In this chapter, the craniofacial approach to juvenile angiofibromas is discussed along with outcomes in a cohort of patients treated using this strategy.