Biopsy should be avoided as to avoid extensive bleeding since the tumor is composed of blood vessels without a muscular coat.Antral sign or Holman-Miller sign (forward bowing of posterior wall of maxilla) is pathognomic of angiofibroma.DSA (digital subtraction angiography)  of carotid artery to see the extension of tumors and feeding vessels

Differential diagnosis
Antro-choanal polyp (benign non neoplastic growth)
Rhinosporidiosis (as bleeding point is here too)
Malignancy—nasopharyngeal carcinoma, lymphoma, plasmacytoma, rhabdomyosarcoma
Chordoma
Nasopharyngeal cyst
Pyogenic granuloma

Staging
There are many different staging- systems published. One of the most used is that of Radkowsky:

Treatment
Treatment for Nasopharyngeal angiofibroma (JNA) is primarily surgical. The tumor is primarily excised by external or endoscopic approach. Medical treatment and radiation therapy are only of historical interest.External approaches:
transpalatine approach
transpalatine + sublabial (Sardanas) Approach
infratemporal Approach
nasal endoscopic Approach
transmaxillary Approach
maxillary swing Approach or Facial translocationEndoscopic approach  is an excellent tool in primary and recurrent JNA, it allows visualisation and precise removal of the lesion. Preoperative embolisation of tumour may be of some use in reducing intraoperative bleeding.Direct visualization is not common-
If the tumor is limited to nasopharynx and nose, for endoscopic approach or Wilsons transpalatal approach is used. It can be extended into Sardanas approach if the tumor extends laterally. For tumors of infratemporal fossa, Maxillary Swing approach is used. Transmaxillary Le Fort 1 approach is used for tumors extending into maxillary and ethmoid sinuses and pterygopalatine fossa. If the tumor extend up to the cheek, for Weber–Ferguson approach should be used. Prognosis
Prognosis for nasopharyngeal angiofibroma is favorable. Because these tumors are benign, metastasis to distal sites does not occur.
Haloperidol decanoate, sold under the brand name Haldol Decanoate among others, is a typical antipsychotic which is used in the treatment of schizophrenia. It is administered by injection into muscle at a dose of 100 to 200 mg once every 4 weeks or monthly. The dorsogluteal site is recommended. A 3.75-cm (1.5-inch), 21-gauge needle is generally used, but obese individuals may require a 6.5-cm (2.5-inch) needle to ensure that the drug is indeed injected intramuscularly and not subcutaneously. Haloperidol decanoate is provided in the form of 50 or 100 mg/mL oil solution of sesame oil and benzyl alcohol in ampoules or pre-filled syringes. Its elimination half-life after multiple doses is 21 days. The medication is marketed in many countries throughout the world. See also
List of antipsychotics § Antipsychotic esters


== References ==