Juvenile Angiofibroma

Juvenile nasopharyngeal angiofibroma: current treatment modalities and future considerations

“…MRI is especially advantageous at the skull base because intracranial involvement is the crucial factor on which operative morbidity and success rest. In the radiological evaluation of JNA, intracranial extension is usually extraduraldestroying bone at the skull base, extending adjacent to the dura, but rarely invading the dura [16]. [15] Angiography and embolization of JNA If a patient is a surgical candidate, preoperative carotid angiography is in order for the complete blood supply of the tumor to be demarcated (Fig.…”

“…Hormonal therapy such as androgen or estrogen has been advocated in the past as a way to decrease the bulk and vascularity of JNA, but angiographic embolization makes hormonal therapy undesirable and unnecessary [16].…”

“…Embolization should be performed 24 hours preoperatively because JNA is known to achieve rapid revascularization [16].…”

“…However, Carrau et al [16] observed that when the pterygopalatine or infratemporal fossae are involved, the tumor may be treated exclusively via nasal endoscopy.…”

“…Using endoscopy, successful treatment was obtained in a number of surgical cases where endoscopic and endoscopic assisted-surgery were used exclusively in 11 patients [16]. Rogers [31] reported 20 patients, using Radkowski staging -4 patients (stage I), 7 patients (stage II) and 9 patients (stage IIIA).…”