Digital subtraction angiography and pre-operative embolization to the supplying artery for the diagnosis and surgical treatment of nasopharyngeal angiofibroma

ObjectiveTo investigate the practical value of digital subtraction angiography(DSA) in the diagnosis of nasopharyngeal angiofibroma and pre-operative embolization to the main supplying artery for the surgical treatment of this lesion. Methods Sixteen cases with nasopharyngeal angiofibroma were included in this study. They were all given DSA for the diagnosis of the lesion and selected embolization to block the main supplying artery to the tumor before operation. Then,these patients were all operated on to remove the tumor under nasal endoscope after 2 to 7 days following the embolization. Results The procedure of DSA made the diagnosis of nasopharyngeal angiofibroma more definite and all of them were shown being the ipsilateral internal maxillary artery as the main supplying vessel to the tumor, except one with the ipsilateral ascending pharyngeal artery and other one with the ipsilateral internal carotid artery as the co-supplying vessel. 16 cases were all successfully blocked to the supplying artery and operated on under nasal endoscope to remove the tumor, totally excised among 15 cases and largely removed in one case.Bleeding was obviously reduced during the period of operation and no severe complications were occurred during and/or after the surgery. Conclusions DSA for nasopharyngeal angiofibroma can clearly display the invading range of this lesion,supplying arteries to the tumor and some other important features of the tumor.Selected pre-operative embolization to the supplying arteries of the tumor can largely reduce bleeding during the period of operation, improve the safety of the surgery and increase the rate of total tumor removing. All these are beneficial to the surgery performed under nasal endoscope for this kind of tumor.