Endoscopic Resection of Juvenile Nasopharyngeal Angiofibroma (JNA)

Edited by: Edward El Rassi, MD

Highlights:

• Pre-operative embolization is performed for this vascular tumor.
• Wide exposure prior to manipulation of the tumor, including sphenoethmoidectomy and removal of anterior wall of the pterygopalatine fossa, allows for safe and complete resection
• For tumors with a large nasopharyngeal component, bimanual delivery is accomplished with trans-oral placement of a finger into the nasopharynx, so that the tumor can be pushed through the choana to allow for removal through the nose.

Keep in Mind:

• Despite preop embolization, ligation of the SPA may be performed to ensure satisfactory intraoperative hemostasis.
• These tumors have a rubbery consistency and pseudocapsule which allows for good separation from underlying tissue.