Preoperative transcatheter arterial embolization successfully minimizes intraoperative bleeding in juvenile nasopharyngeal angiofibroma even without internal carotid artery branch embolization: A report of two cases

Juvenile nasopharyngeal angiofibroma (JNA) is a histopathologically benign and highly vascular neoplasm of the nasopharynx. Surgery is the treatment of choice for this type of tumor, but its highly vascular nature could result in profuse and uncontrollable bleeding. Preoperative transcatheter arterial embolization offers an effective and minimally invasive modality for reducing intraoperative blood loss. We report 2 cases of JNA in a 17-year-old male and 14-year-old male who underwent preoperative embolization of external carotid artery branch using gelatin sponge slury and polyvinyl alcohol. Even without internal carotid artery branch embolization, both of our reported cases had intraoperative blood loss of 1100 mL and 1300 mL which are less than the previously reported mean blood loss of 1428 mL in patients who underwent both internal and external carotid artery branch embolization.