Juvenile Nasopharyngeal Angiofibroma

UT Southwestern Medical Center’s Comprehensive Skull Base Program provides exceptional treatment for rare and complex skull base disorders such as juvenile nasopharyngeal angiofibroma, combining a multidisciplinary approach with the latest techniques and technology. 

Patients with juvenile nasopharyngeal angiofibroma have access to a world-class neurological surgery center, a state-of-the-art neuro intensive care unit, and coordinated post-surgical recovery services.

Expert Care for Optimal Results

Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign tumor of the nasopharynx, the space at the back of the nasal cavity that connects the nose to the mouth. 

These tumors tend to develop in young men between 10 and 25 years old. Androgen hormones can play a part in the growth of these tumors. 

Specialists at UT Southwestern are experts in applying the latest in image guidance and microsurgical techniques to treat JNA while preserving quality of life for each patient.

Symptoms

Common symptoms of JNA include nasal obstruction and severe or repeated nosebleeds. If the tumor grows large enough, it can cause:

• Change in facial appearance
  
• Complete obstruction of both sides of the nose
  
• Facial pain or headaches
  
• Visual disturbance 

Over time, the tumor can invade the eye socket or cranial cavity, causing blindness or other significant neurologic problems.

Diagnosis

At UT Southwestern, physicians use nasal endoscopy as well as computed tomography (CT) or magnetic resonance imaging (MRI) studies to diagnose JNA. 

Because these tumors occur in a typical location in the nasopharynx and have characteristic features on radiologic studies, a biopsy is not usually required for planning treatment.

Treatment for Juvenile Nasopharyngeal Angiofibroma

Surgical removal is the primary treatment for JNA. These tumors have a large blood supply and many blood vessels, which could cause significant blood loss during surgery. To reduce the amount of bleeding at the time of surgical removal, a procedure called angiography with embolization is frequently performed the day before surgery. 

The traditional method for surgically removing JNA involved facial incisions or cuts through the roof of the mouth. Modern endoscopic techniques have replaced these older approaches. With appropriate equipment and expertise, even very large tumors can be removed with an endoscopic approach through the nostrils. This approach results in an unchanged external appearance, reduced discomfort after the surgery, and shorter healing times. 

Because JNA tumors have the potential to recur after surgical removal, regular nasal endoscopic examination and imaging studies are often used to monitor for tumor recurrence in the years after surgery. Recurrent tumors that demonstrate growth are usually removed. 

In rare, very advanced, or aggressive cases, radiation therapy can be considered as a treatment option.

Clinical Trials and Research

Patients also benefit from the leading research conducted at UT Southwestern, which often includes clinical trials offered at few other centers in the country and helps speed better treatment to patients.