Preoperative embolization of juvenile nasopharyngeal angiofibroma using medium to large size particles

Introduction. Juvenile nasopharyngeal angiofibroma are benign tumors, with locally aggressive behavior. Preoperative tumor embolization polyvinyl alcohol particles can reduce intraoperative blood loss and facilitate surgical resection. Case outline. A 16-year-old male, was admitted to hospital due profuse epistaxis sense of nose fullness. MDCT examination showed a mass in the right nasal cavity extension maxillary sinus ethmoidal cells on right, left cavity. It rested septum, but without bone destruction. After application contrast agent, described became intensely opacified. Preprocedural digital subtraction angiography external internal carotid arteries both sides extensive pathological vascularization, which received main contribution from branches artery and, lesser extent, side. Due danger penetration particle agent smaller diameter into orbital possible retrograde migration artery, we decided apply larger (500-700 ??) than prescribed by modern standards. Tumor completely surgically removed third day after embolization, patient discharged any neurological deficit. Control enhanced MDCT-s were performed at seventh month surgery no residue or recurrence. Conclusion. The use gave satisfactory results during operation - excision tumor, when dangerous anastomoses do not allow be safely significant nor systemic complications.