Juvenile nasopharyngeal angiofibroma – literature review and case series

Abstract

Juvenile nasopharyngeal angiofibroma is a rare benign tumour of vascular origin found in adolescent males, originating around the sphenopalatine foramen. Although the exact pathogenesis of the tumour is not yet known, natural history and growth patterns can be predicted. JNA progressively involves the nasopharynx, nasal cavity, paranasal sinuses, pterygopalatine fossa, infratemporal fossa and, in severe cases, an orbital or intracranial extension can be seen. Early diagnosis based on clinical examination and imaging is mandatory to ensure the best resectability of the tumour, as small to moderate tumours can be managed exclusively endoscopically. Preoperative angiography can reveal the vascular sources and allow embolization to prevent significant bleeding. We present a brief literature review followed by our case series of endoscopic removal of 7 juvenile nasopharyngeal angiofibromas.

Juvenile Nasopharyngealangiofibroma: Our Experience and Literature Review

“…Another unique technique is to keep tumor in gauze soaked in a vasoconstrictor, this helps to dissect tumor in a relatively bloodless field. 24 Some structures of nose are removed for better access and dissection which include nasal septum, posterior wall of maxillary sinus, turbinates and some part or whole of lateral nasal valve. Sometimes a septectomy is done by removing some part of nasal septum anteriorly to create a septal window and facilitate instrumentation from other nasal cavity using a four handed technique.…”