Juvenile nasoangiofibroma: series of cases and experience in endovascular and surgical management in a fourth level center

Abstract

Introduction: Juvenile nasoangiofibroma (JN) is a benign, highly vascularized tumor, observed in male adolescents, which has a very aggressive behavior due to its rapid growth and extension to adjacent structures. Management is surgical resection of the lesion; however, given its high risk of intraoperative bleeding, embolization before the intervention has been chosen in recent years, currently with materials such as embolic fluid (Onyx) and microparticles which reduce complications. Objective: Describe and evaluate the embolizing agent used, main nutrient artery, percentage embolized, the time elapsed between embolization and surgical intervention, blood transfusion requirement, complications, and recurrence related to the UMPC classification system. Materials and methods: This was a descriptive, retrospective study, in which 9 patients with JN confirmed by histopathological study were taken. All patients received endovascular management and subsequently underwent surgical resection. 9 male patients with a diagnosis of NJ with an average age of 19 years were identified, who underwent transarterial embolization; 5 cases with onyx 18, and 4 cases with microparticles of different sizes, obtaining a percentage of obliteration of the tumor volume. 85%; 2 cases of complications requiring transfusion of blood products with subsequent improvement, 1 recurrence after 12 months. Conclusion: Based on our experience, it could be concluded that endoscopic surgical management, preceded by embolization with either embolic fluid or microparticles, is effective in managing JN.