Surgical management of juvenile nasopharyngeal angiofibroma, with and without pre-operative embolization. A comparative analysis

ABSTRACT

To compare the outcome of surgical excision of juvenile nasopharyngeal fibroma [JNF] with and without pre-operative embolization. A descriptive study. Conducted at departments of Otolaryngology of Peoples Medical College, Nawabshah and Jinnah Post Graduate Medical Centre Karachi between Jan 1997 to Dec1999. 23 cases with high clinical and radiological [C.T scan] indices of suspicion of nasopharyngeal angiofibroma were included in this study. Patients were divided into two groups [A and B]. Group A comprising of 10 patients who underwent pre-operative embolization. Group B comprising of 13 patients underwent surgery without preoperative embolization. 1. To compare pros and cons between surgical procedures with and without pre-operative embolizaion. 2. To compare the chances of recurrence after excision of JNF with and without embolization. Group A indicated 1- Significant reduced blood loss [average 200cc]. 2-Recurrence - 3 cases. 3- facial numbness - 1 case. 4- Total cost incurred Rs 15000. Group B 1- Average blood loss of 2000cc. 2- Recurrence-nil. Surgical excision of INF with pre-operative embolization has an advantage of much reduced blood loss during surgery but the rate of recurrence is almost nil in patients who underwent excision of JNF without pre-operative embolisation