Using onyx as an intra-arterial embolization to the main feeder artery in hypervascular nasopharyngeal angiofibroma gives a better outcome—a case report

Abstract

Intra-arterial embolization is an interventional procedure that reduces bleeding and blood flow to tumor masses. A neurointerventionalist with extensive experience can successfully perform this procedure, specifically someone who has conducted over 100 digital subtraction angiography procedures. The expert must possess the skills to use intra-arterial catheters and embolization materials effectively and safely. Recent advancements in embolization techniques, utilizing materials such as onyx and N-butyl-2-cyanoacrylate, have shown promising results as a perioperative treatment for nasopharyngeal angiofibroma (NA). Typically, embolization is performed 24–48 hours before surgery, significantly reducing blood volume. Occurs due to the absence of angiogenesis within a week following the embolization. We present the cases of three patients, aged 10, 15, and 16, who initially exhibited symptoms such as epistaxis (nosebleeds), nasal congestion, and facial pain. Based on family histories, their symptoms progressively worsened to the extent that they could not engage in normal daily activities. Anterior rhinoscopy revealed a mass in the nasal cavity, and biopsy results confirmed the diagnosis of NA. This case report highlights the benefits of tumor embolization before tumor resection, as embolization techniques enable the medical team to identify tumor cells in feeder arteries and prepare the necessary blood supply for surgery.

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