Efficacy of preoperative transarterial embolization in restricting intraoperative bleeding volume based on surgical approach and staging according to Radkowski Classification in juvenile nasopharyngeal angiofibroma

Abstract

BACKGROUND: This study aimed to assess the efficacy of preoperative transarterial embolization (TAE) based on surgical approach and staging according to Radkowski Classification in juvenile nasopharyngeal angiofibroma (JNA).METHODS: This retrospective study utilized a cross-sectional design, analyzing medical record data from 2014 to June 2023. The study population comprised all patients diagnosed with JNA who underwent extirpation surgery, both with and without preoperative embolization. Statistical analysis was conducted using SPSS version 29.0 (SPSS Inc., Chicago, IL, USA), with a P value of less than 0.05 considered statistically significant.RESULTS: This study included 41 samples: 31 patients (75.6%) underwent preoperative TAE, while 10 (24.4%) did not. Among them, 23 patients (56.09%) had a transpalatal approach, and 18 (43.90%) had a lateral rhinotomy. Radkowski’s Classification showed 9 patients (21.95%) at stage IA, 8 (19.51%) at stage IB, 4 (9.75%) at stage IIA, 16 (38.02%) at stage IIB, and 4 (9.75%) at stage IIIA, with no patients in stages IIC or IIIB. The mean intraoperative blood loss was 833.39±630.2 cc for TAE and 2285±1726 cc for non-TAE groups. Significant differences in blood loss were found overall and in stage IIB (P=0.012 and 0.009, respectively), but not for surgical approach or stage IIIA.CONCLUSIONS: Preoperative TAE generally reduces intraoperative bleeding in JNA patients. Although no statistically significant difference was observed in bleeding volume between those with and without TAE for the transpalatal approach, lateral rhinotomy, and stage IIIA, the overall distribution of bleeding volumes underscores the importance of preoperative TAE in minimizing intraoperative bleeding.

Access to Document

Other files and links

• Link to publication in Scopus

Fingerprint