Angiographic Profile of Patients with Recurrent Juvenile Nasopharyngeal Angiofibroma
Dr Habie Thomas, Associate Professor, Dept of ENT, Christian Medical College, Vellore, India
Authors List
Samuel HT., Sara KB., Sundaresan RV., Thomas R., Christian Medical College, Vellore, India
Introduction: Juvenile nasopharyngeal angiofibroma (JNA) is a unique benign tumour accounting for 0.05 – 1% of head and neck tumors.1 Tumour recurrence remains a major challenge despite highly effective surgical treatment owing to its biological behaviour. Recurrence rates for JNA have been reported from approximately 20% to 50%.2
Aims: The aim of this study was to describe the diversity in the vasculature of recurrent JNA tumours.
Methods: This retrospective observational study was conducted at the Department of ENT in a quaternary medical centre in South India. Adolescent males operated for recurrent JNA with preoperative angiography between January 2005 and January 2025 were included in the study. Variables such as age, duration of symptoms, imaging findings including Radkowski staging, and preoperative angiography findings were noted.
Results: 28 patients were included in this study. 85% tumors had multiple vessels supplying the tumour (>2 vessels). The major feeder was the ipsilateral internal maxillary artery (IMAX) in 85% cases followed by contralateral IMAX (40%). 17% cases had ipsilateral ascending pharyngeal artery as a significant feeder. Other significant feeders were ipsilateral internal carotid artery (32%), vidian artery (6%), branches of contralateral internal carotid artery.(22%)
Conclusion: The relationship between recurrent tumours and vascularity is a unique challenge in the strategic preoperative planning for recurrent JNA, which is paramount for successful outcomes. Despite the recurrent nature of the tumour and previous history of embolisation, the ipsilateral internal maxillary artery is the major feeder for recurrent JNA.
References
(1) Lund VJ, Stammberger H, Nicolai P, Castelnuovo P et al. European position paper on endoscopic management of tumours of the nose, paranasal sinuses, and skull base. Rhinol Suppl. 2010 Jun; 22:1–143.
(2) Fyrmpas G, Konstantinidis I, Constantinidis J. Endoscopic treatment of juvenile nasopharyngeal angiofibromas: Our experience and review of the literature. Eur Arch Otorhinolaryngol. 2012 Feb; 269(2):523–9.
Samuel HT., Sara KB., Sundaresan RV., Thomas R., Christian Medical College, Vellore, India
Introduction: Juvenile nasopharyngeal angiofibroma (JNA) is a unique benign tumour accounting for 0.05 – 1% of head and neck tumors.1 Tumour recurrence remains a major challenge despite highly effective surgical treatment owing to its biological behaviour. Recurrence rates for JNA have been reported from approximately 20% to 50%.2
Aims: The aim of this study was to describe the diversity in the vasculature of recurrent JNA tumours.
Methods: This retrospective observational study was conducted at the Department of ENT in a quaternary medical centre in South India. Adolescent males operated for recurrent JNA with preoperative angiography between January 2005 and January 2025 were included in the study. Variables such as age, duration of symptoms, imaging findings including Radkowski staging, and preoperative angiography findings were noted.
Results: 28 patients were included in this study. 85% tumors had multiple vessels supplying the tumour (>2 vessels). The major feeder was the ipsilateral internal maxillary artery (IMAX) in 85% cases followed by contralateral IMAX (40%). 17% cases had ipsilateral ascending pharyngeal artery as a significant feeder. Other significant feeders were ipsilateral internal carotid artery (32%), vidian artery (6%), branches of contralateral internal carotid artery.(22%)
Conclusion: The relationship between recurrent tumours and vascularity is a unique challenge in the strategic preoperative planning for recurrent JNA, which is paramount for successful outcomes. Despite the recurrent nature of the tumour and previous history of embolisation, the ipsilateral internal maxillary artery is the major feeder for recurrent JNA.
References
(1) Lund VJ, Stammberger H, Nicolai P, Castelnuovo P et al. European position paper on endoscopic management of tumours of the nose, paranasal sinuses, and skull base. Rhinol Suppl. 2010 Jun; 22:1–143.
(2) Fyrmpas G, Konstantinidis I, Constantinidis J. Endoscopic treatment of juvenile nasopharyngeal angiofibromas: Our experience and review of the literature. Eur Arch Otorhinolaryngol. 2012 Feb; 269(2):523–9.
