Surgical Management of Juvenile Nasopharyngeal Angiofibroma

Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign but locally aggressive vascular tumour occurring predominantly in adolescent males. Surgical resection remains the mainstay of treatment, with strategies evolving to minimise intraoperative blood loss, reduce morbidity and limit recurrence. Preoperative devascularisation through arterial embolization has become routine, enabling safer dissection and clearer operative fields. Advances in imaging and tumour staging guide the choice between endoscopic endonasal and external approaches. Endoscopic techniques have gained prominence for small to intermediate lesions, offering reduced facial morbidity and shorter hospital stay. Larger or laterally extensive tumours often require external access, such as midfacial degloving or combined approaches, to ensure complete excision. Multidisciplinary collaboration among otolaryngologists, interventional radiologists and anaesthetists is critical to optimise outcomes. Long-term follow-up focuses on endoscopic surveillance and imaging to detect and manage recurrence, which remains a key challenge, particularly in cases with skull-base involvement or extensive lateral spread.

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Surgical Management of Juvenile Nasopharyngeal Angiofibroma publication trend

The graph below shows the total number of articles in surgical management of juvenile nasopharyngeal angiofibroma across all publications each year (not limited to Nature Index journals).

Technical terms

Juvenile Nasopharyngeal Angiofibroma: rare, benign vascular tumour of the nasopharynx in adolescent males.

Preoperative Embolization: procedure to occlude tumour feeding vessels before surgery to reduce bleeding.

Endoscopic Endonasal Approach: minimally invasive resection via nasal passages using endoscopes.

External Surgical Approach: open facial techniques such as midfacial degloving or lateral rhinotomy.

Fisch Classification: staging system based on tumour extension and vascular anatomy.

Devascularization: reduction of blood supply to a lesion, typically by embolic agents.

References

1. Juvenile Angiofibroma: Evolution of Management. International Journal of Pediatrics (2011).
2. Preliminary Experience with the Percutaneous Embolization of Juvenile Angiofibromas Using Only Ethylene-Vinyl Alcohol Copolymer (Onyx) for Preoperative Devascularization Prior to Surgical Resection. American Journal of Neuroradiology (2012).
3. Twenty Years of Experience in Juvenile Nasopharyngeal Angiofibroma (JNA) Preoperative Endovascular Embolization: An Effective Procedure with a Low Complications Rate. Journal of Clinical Medicine (2021).