Preoperative direct puncture embolization of advanced juvenile nasopharyngeal angiofibroma in combination with transarterial embolization: an analysis of 22 consecutive patients

Cardiovascular and Interventional Radiology
Ming-Ming LvDong Chen

Abstract

This study was designed to evaluate the clinical application of preoperative auxiliary embolization for juvenile nasopharyngeal angiofibroma (JNA) by direct puncture embolization (DPE) of the tumor in combination with transarterial embolization (TAE). The study included 22 patients. An 18-gauge needle was used to puncture directly into the tumor, and 20-25 % N-butyl cyanoacrylate was injected under the guidance of fluoroscopy after confirming the placement of the needle into the JNA and no leaking into the surrounding tissue. Tumors were obstructed later via TAE. The supplying arteries of JNA were from branches of the internal carotid and external carotid arteries. Control angiography showed the obliteration of contrast stain in the entire tumor mass and the distal supplying arteries disappeared after DPE in combination with TAE. Surgical resection was performed within 4 days after embolization and none of the patients required blood transfusion. The use of DPE in combination with TAE was a safe, feasible, and efficacious method. It can devascularize effectively the JNAs and reduce intraoperative bleeding when JNAs are extirpated.

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Citations

Dec 2, 2014·International Journal of Surgery Case Reports·Vevek Parikh, Charles Hennemeyer
Jun 13, 2016·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Raghav MehanN K Shyam Kumar
May 21, 2015·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Ljubisa BorotaTomas Ekberg
Oct 2, 2020·The Laryngoscope·Stéphane GargulaBenjamin Verillaud
Jul 7, 2018·Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India·M Mujtaba KhanD Ranganath Swamy

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