[Angiographic evaluation and embolization of juvenile nasopharyngeal angiofibroma].
OBJECTIVE
In juvenile nasopharyngeal angiofibroma (JNA), analysis of tumor extension and blood supply is useful for controlling intraoperative bleeding and helps in determining the appropriate surgical approach. The purpose of this study was to evaluate angiographic findings and the efficacy and benefits of preoperative embolization of JNA.


METHODS
Twenty-one male patients with JNA (mean age 13.3 years) were included in this study. The tumors were embolized with particles of gel foam. Surgical removal was achieved through transantral approach (n=2), lateral rhinotomy (n=13), midfacial degloving (n=4), and endonasally (n=2).


RESULTS
The blood supply was exclusively homolateral in 18 patients, deriving mainly from the external carotid artery, and bilateral in three. There were no connections between the branches of the internal and external carotid arteries. Intratumoral embolization was achieved in all patients. No major complications occurred. Mean blood loss during surgery was 560 ml. The recurrence rate was 14%.


CONCLUSIONS
Preoperative angiographic evaluation and embolization of JNA are important tools for planning surgical approach. Embolization reduces significantly the intraoperative blood loss, minimizes the need of blood transfusion, and makes resection easier.
Giavroglou
C
C
Radiologisches Institut der Aristoteles-Universität Thessaloniki, AHEPA-Hospital, Griechenland.
Constantinidis
J
J
Triaridis
S
S
Daniilidis
J
J
Dimitriadis
A
A
D000293:Adolescent; D018322:Angiofibroma / Q000000981:diagnostic imaging* / Q000628:therapy*; D000792:Angiography / Q000379:methods; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D016896:Treatment Outcome