Investigation of choice for nasopharyngeal angiofibroma: (A) X-ray, (B) MRI, (C) Plane-CT, (D) CT-contrast
Answer is D. Computed tomography (CT) scan of the head with contrast enhancement is now the investigation of choice. It has replaced conventional radiographs. It shows the extent of a tumour, bony destruction or displacements. Anterior bowing of the posterior wall of maxillary sinus often called antral sign or Holman-Miller sign is pathognomic of angiofibroma (Ref: Diseases of Ear, Nose and Throat, P.L Dhingra, 7th edition, page 280)