Transoral adenoidectomy excision of juvenile nasopharyngeal angiofibromas

Objectives:We describe a minimally invasive technique for excision of selected juvenile nasopharyngeal angiofibromas (JNAs) using indirect visualization of the nasopharynx.Methods:An observational case series with follow-up of 9 months to 3 years was performed. The subjects included 4 teenage boys with early-stage nasopharyngeal angiofibromas. The intervention included computed tomography, magnetic resonance imaging, angiography and embolization, tumor excision, pathologic examination, and follow-up. The outcome measures included blood loss, perioperative morbidity, and surgical cure.Results:Four teenage boys underwent excision of early stage JNAs — 3 with preoperative embolization. The JNAs were excised under indirect mirror guidance with an adenoid curette and the nasopharynx packed. Residual tumor was removed endoscopically. The operative time was less than 1 hour in each case, and blood loss was less than 100 mL. All 4 boys are free of disease.Conclusions:With the advent of refined imaging techniques ...