Evaluation of the effectiveness of preoperative embolization in surgery for nasopharyngeal angiofibroma

Abstract

We retrospectively analyzed the clinical data of 21 patients (22 procedures) with histologically proven nasopharyngeal angiofibromas. Eleven patients underwent preoperative intra-arterial digital subtraction angiography (IADSA) and embolization with Gelfoam. Embolization reduced the intraoperative blood loss from an average of 1136 ml in the non-embolized patients to 677 ml in the embolized cases (P < 0.05) and transfusions from an average of 836 ml to 400 ml (P < 0.01). Results again show that preoperative embolization is effective in reducing intraoperative blood loss.

Clinico-radiological evaluation of Juvenile Nasopharyngeal Angiofibromas: two case reports

“…There is 46% recurrence rate after surgical excision. Angiography is helpful to find the feeder vessel and to embolize it 24-72 hours before surgery to minimize the bleeding [13]. Radiotherapy (30-46 Gy) is indicated in non-operable and recurring cases.…”

Tratamento cirúrgico de nasoangiofibroma sem embolização

“…Most papers in the literature comparing surgical treatment with and without embolization have demonstrated reduced intraoperative blood loss and fewer blood transfusions when embolization is done 10,12 . Blood loss is reduced by 836 to 1200 ml per non-embolized patient; and by 400 to 600 ml per embolized patient [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] .…”

“…Most papers in the literature comparing surgical treatment with and without embolization have demonstrated reduced intraoperative blood loss and fewer blood transfusions when embolization is done 10,12 . Blood loss is reduced by 836 to 1200 ml per non-embolized patient; and by 400 to 600 ml per embolized patient [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] . In terms of blood transfusion, the values ranged between 3 and 4.4 units of red cell pack per patient in the non-embolized group, when compared to 0 to 2 units in the group of embolized patients [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] .…”

Anaesthetic management of endoscopic resection of juvenile nasopharyngeal angiofibroma: our experience and a review of the literature

“…17 Preoperative selective arterial embolisation of the feeding vessels significantly decreased intraoperative blood loss and facilitated the resection of larger tumours. 18,19 Embolisation is typically performed 24-48 hours prior to resection, as after several days the contralateral vessels may became the major contributor to the tumour. The transarterial technique of embolisation is associated with a significant risk of complications, such as numbness, facial palsy, strokes and occlusion of the ophthalmic artery.…”