Preoperative Embolization Followed by Tumor Resection Without Time Interval in Advanced Juvenile Nasopharyngeal Angiofibroma

• Published in: Cardiovascular and interventional radiology Vol. 48; no. 6; pp. 815 - 822
• Main Authors: He, Yu, Hong, Rujian, Wang, Siyu, Wu, Jiawei, Li, Wanpeng, Zhang, Huankang, Xue, Kai, Liu, Quan, Gu, Yurong, Sun, Xicai, Li, Houyong, Sha, Yan, Yu, Hongmeng, Wang, Dehui, Liu, Qiang
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01.06.2025
• Subjects: Adolescent; Adverse events; Anesthesia; Angiofibroma - diagnostic imaging; Angiofibroma - pathology; Angiofibroma - surgery; Angiofibroma - therapy; Blood Loss, Surgical; Cerebral infarction; Child; Child, Preschool; Embolization; Embolization, Therapeutic - adverse effects; Embolization, Therapeutic - methods; Feasibility Studies; Female; Humans; Male; Nasopharyngeal Neoplasms - diagnostic imaging; Nasopharyngeal Neoplasms - pathology; Nasopharyngeal Neoplasms - surgery; Nasopharyngeal Neoplasms - therapy; Patients; Preoperative Care - methods; Retrospective Studies; Time Factors; Treatment Outcome; Tumors; No time interval; Endoscopic resection; Preoperative embolization; Juvenile nasopharyngeal angiofibroma
• ISSN: 1432-086X; 0174-1551; 1432-086X
• DOI: 10.1007/s00270-025-04041-7

This study explored the feasibility and security of the clinical application of preoperative embolization and tumor resection for advanced juvenile nasopharyngeal angiofibroma (JNA) without a time interval, performed on the same date, and under the same general anesthesia (GA). Between December 2020 and December 2023, patients with JNA underwent embolization and resection at our hospital. All patients underwent preoperative embolization using liquid embolic material under GA with partial coil assistance; the tumor was removed immediately under the same GA. Both embolization and resection were performed on the same date in the same hybrid operating room without a time interval. Outcome measures included adverse events, blood loss, residual disease, and recurrence. Complete tumor embolization and complete tumor resection (R0) were achieved in 27 patients under a single GA. 1/27 patient (3.7%) experienced adverse events related to nontarget embolization of the cerebral vessels. However, due to timely detection and treatment, no functional disability occurred after delayed tumor resection and active treatment for cerebral infarction. During a mean follow-up of 12 months, 25/27 patients (92.6%) had no residual tumor seen on imaging or endoscopic evaluation, while residual tumor was observed in 2/27 patients (7.4%). No further treatments were performed. The mean blood loss in tumor resection was 911 mL (100-3400 mL). No interval between preoperative embolization and tumor resection is a feasible and safe treatment modality in patients with advanced JNA.