Impact of preoperative transcatheter arterial embolization on blood loss and surgery time during endoscopic transnasal resection of juvenile angiofibroma

Juvenile nasopharyngeal angiofibroma is the most common benign tumor of the nasopharynx in adolescent males, often presenting with aggressive local invasion and severe, potentially life‑threatening epistaxis. Its highly vascular nature complicates surgical resection, making preoperative transarterial embolization an important step to reduce intraoperative blood loss and improve outcomes. Evaluating the effectiveness of different embolization techniques is critical for optimizing endoscopic surgical treatment and minimizing complications. This study was driven by an ongoing need to improve surgical safety and efficiency, especially as endoscopic approaches become the standard of care in managing this challenging tumor.

The purpose of the study. Тo determine the effect of preoperative transcatheter arterial embolization on intraoperative blood loss and surgery time for endoscopic transnasal resection of juvenile nasopharyngeal angiofibroma.

Methods and materials. A retrospective analysis was conducted on thirty adolescent male patients who received surgical treatment at the University Medical Center from February 2014 to December 2023. The cohort was divided into two groups: those who underwent preoperative transcatheter arterial embolization (n = 19) and those who did not (n = 11). The characteristics compared included blood loss and the duration of surgery.

Results. Patients who underwent preoperative transcatheter arterial embolization experienced a significant reduction in intraoperative blood loss across all stages of juvenile nasopharyngeal angiofibroma. Although preoperative transcatheter arterial embolization reduced the time required for surgery, the results were not statistically significant.

Conclusions. Preoperative transcatheter arterial embolization significantly enhances surgical outcomes by effectively reducing intraoperative bleeding during the resection of juvenile nasopharyngeal angiofibroma.

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