Super-selective artery embolization prior to endoscopic resection of nasopharyngeal angiofibroma

Objective To evaluate the use of super-selective artery embolization prior to endoscopic resection of juvenile nasopharyngeal angiofibroma (JNA). Methods Intra-arterial digital subtraction angiography (IADSA) and selective artery embolization were performed in 8 cases of JNA before nasal endoscopic resection. The supplying arteries originated from the maxillary and the pharyngeal ascending branches arising from external carotid artery were embolized with gelatin sponge or PVA. Results Complete occlusion of blood supply to the lesion was seen in 90% of cases after embolization, with significantly less blood loss during the subsequent procedures. The optimal timing for the operation appeared to be 3~5 days after the embolization. Conclusion Preoperative artery embolization for juvenile nasopharyngeal angiobroma may result in less blood loss. Considerable outcomes for stages Ⅰ to Ⅲ lesions may be expected with selective artery embolization followed by endoscopic resection under direct vision.