Association of Preoperative Embolization and Vascularization Patterns With Outcomes in Juvenile Nasopharyngeal Angiofibroma Resection.
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BACKGROUND: Preoperative vascular embolization (PVE) is commonly used in managing juvenile nasopharyngeal angiofibroma (JNA) to improve outcomes. However, few studies have evaluated how embolization patterns and vascular features affect prognosis. METHODS: A 15-year retrospective review was performed on 44 patients with JNA undergoing surgery at one institution. Data included demographics, vascular supply, embolization techniques, surgical outcomes, and recurrence. RESULTS: Forty-three patients underwent PVE. Most tumors were embolized transarterially (93.0%) using polyvinyl alcohol-based agents (79.1%). The internal maxillary artery was most commonly embolized (93.0%). Internal carotid artery supply was present in 34.9%, and more than two vessels were embolized in 23.3%. Postembolization tumor blush occurred in 60.5%, with a median of 5% of the pre-embolization blush remaining after embolization. Neither internal carotid involvement, number of vessels embolized, nor residual blush significantly impacted operative time, surgical outcomes, or recurrence. CONCLUSION: With effective embolization, vascular complexity might not affect JNA resection outcomes. Multicenter studies are required to confirm those findings.