Juvenile Nasopharyngeal Angiofibroma

Juvenile Nasopharyngeal Angiofibroma: Symptoms, Diagnosis, and Treatment

Juvenile Nasopharyngeal Angiofibroma, or JNA for short, is a tumor that usually develops in minors between 7 and 17 years of age, particularly males. It is a common benign tumor of the sphenopalatine region that causes nasal obstruction. Despite the fact that JNA is a commonly reported concern, diagnosing the issue is far from simple. In most cases, physicians are unable to diagnose the tumor or determine its exact site of origin until they have grown to a considerable size. Most practitioners, however, believe that these tumors start developing in the posterior choanal tissues in the sphenopalatine foramen region. Let’s take a closer look at all that follows.

Symptoms

JNA, if left unattended for long enough, may completely obstruct both nostrils, which may eventually cause nasal obstruction and nosebleeds. Other symptoms include:

These symptoms, however, point towards the fact that the tumor has become too large and requires the immediate attention of an ENT specialist.

Diagnostic Options

Radiology

Radiological or imaging studies are the most recommended method to diagnose JNA. As these tumors have large blood vessels within them, a biopsy is usually inadvisable as it involves the risk of brisk haemorrhage or staging.

Computerized Tomography

Computerized Tomography, commonly known as “CT scan”, is another option leveraged by ENT specialists, to diagnose JNA. The scan helps doctors in determining the presence of a lobulated non-encapsulated soft-tissue mass in the center of the sphenopalatine foramen. It is particularly useful to delineate any bony changes. Findings include but may not be limited to:

  • Visualisation of a nasopharyngeal mass
  • Erosion of the medial pterygoid plate
  • Opacification of the sphenoid sinus
  • Widening of the pterygopalatine fossa

Magnetic Resonance Imaging

Magnetic Resonance Imaging, or MRI for short, is a particularly useful tool to find out if the tumor has extended intracranially, into the orbit, or other sinuses.  This study is useful for visualizing soft tissue extension of the tumor.

Treatment of Juvenile Nasopharyngeal Angiofibroma

In the past, the treatment of JNA involved face incisions or radiotherapy. Both these approaches, however, are no longer practiced. Most practitioners currently recommend an endoscopic surgical procedure to treat JNA, for two reasons; (1) shorter recovery time compared to traditional procedures, and (2) no effect on the facial appearance post surgery. Some tumors are too large to be removed endoscopically but the majority can be removed in a minimally invasive fashion without making cuts or incision on the face.

Must Read: Nasal Obstruction 101: Discussing Possible Surgical Treatments

Conclusion

JNA is highly vascular, and can be life threatening, if ignored for long. The tumor can grow large enough to get into the orbit, which may cause blindness and neurological issues. Timely diagnosis and the right treatment can, however, get help patients get rid of this tumor. Therefore, if you or someone you know is experiencing any of the symptoms of JNA discussed in the post, our team of ENT specialists is here to help. We specialize in advanced endoscopic procedures, including septal deviation correction and turbinate reduction, to diagnose and manage JNA and other ENT issues. To schedule a consultation, click here.

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