Angiography and Preoperative Superselective Embolization of Nasopharyngeal Angiofibroma

Objective To study the clinical value of preoperative superselective embolization of nasopharyngeal angiofibroma.Methods 14 patients with nasopharyngeal angiofibroma diagnosed by CT and MRI,and proved surgically and pathologically were included in this study.Angiography of bilateral external carotid artery and internal carotid artery as well as vertebral artery was performed in all cases. The external carotid arterial blood supply of tumors were superselectively embolized with 100～300 μm particles of gelfoam or polyvinyl alcohol(PVA). Surgical resection was performed post-embolization 1 to 3 days. Results The main feeding vessels of tumors were the internal maxillary artery in 9 patients,the internal maxillary artery and ascending pharyngeal artery in 4 patients,the internal maxillary artery,ascending pharyngeal artery and the branches of internal carotid artery in one patient. Preoperative endovascular embolization of the branches of external carotid artery with microcatheter was achieved in all patients. After embolization,tumor stains disappeared completely in 8 patients and partially in 6 patients. The rate of total resection was 92.8%(13/14).The mean amount of haemorrhage during operation was 420 ml and the mean operation duration was 150 min.No major complications were relevant to embolization occurred.Conclusion Preoperative intravascular embolization of nasopharyngeal angiofibroma with microcatheter is a safe and effective method.