Endoscopic embolization and resection of juvenile nasopharyngeal angiofibromas

Juvenile nasopharyngeal angiofibromas (JNAs) are rare tumors found exclusively in adolescent boys. Over the last 10 years, endoscopic approaches for resection of JNAs have been used, yielding acceptable results and relatively low recurrence rates. Endoscopic resection preceded by embolization has been shown to be superior to open approaches from a blood loss and hospital stay standpoint. We have performed the first direct intratumoral embolization using the new liquid embolic substance Onyx in cooperation with neurosurgery through endoscopic visualization of the tumor. This article describes our technique for embolization and endoscopic resection of JNAs.