Preoperative external carotid artery embolization of nasopharyngeal angiofibroma:its clinical application

Objective:To evaluate super selective external carotid artery embolization before transnasal endoscopic resection in treating nasopharyngeal angiofibroma. Methods: Super selective external carotid artery embolization was performed in 20 patients with nasopharyngeal angiofibroma one to three days before transnasal endoscopic resection was carried out. The clinical data,including the volume of blood loss during the surgery, the operative time and the complications,were retrospectively analyzed. Results: Super selective external carotid artery embolization was successfully preformed in all 20 patients,which was followed by the transnasal endoscopic resection within 3 days. The average volume of blood loss during the surgery was 155 ml and the total time of operation was 75 minutes. Mild complications occurred in 6 patients after embolization, which were subsided after symptomatic management. No serious complications occurred after surgical resection. The mean hospitalization days of the patients were 3.5 days. Conclusion: Preoperative super selective external carotid artery embolization of nasopharyngeal angiofibroma can markedly reduce the blood loss during surgical resection, apparently shorten the operative time and effectively lower the occurrence of complication after the operation. Super selective external carotid artery embolization combined with transnasal endoscopic resection should be regarded as an ideal therapy for nasopharyngeal angiofibroma. (authors)