Modern Approach to Juvenile Nasopharyngeal Angiofibroma: A Literature Review

Juvenile nasopharyngeal angiofibroma (JNA), also known as juvenile angiofibroma or nasal juvenile angiofibroma, is a benign tumour of vascular origin that occurs predominantly in adolescent males at the average age of 15 (10-25) and is extremely rare in both females and older males. The JNA is considered histopathologically benign, but it behaves as a locally aggressive neoplasm which can destructively erode adjacent soft tissue, cartilage and bone and may provoke complications due to extension to the orbit in approximately 30 % and intracranial invasion in 10-20 % of all tumours. After years of research, still there is no universal consensus on the most successful surgical method, the therapeutic choice depends on the individual pattern, tumor behaviour and surgeon experience. Regardless of the surgical method chosen for the treatment of nasopharyngeal angiofibroma, no doubt is there that anaesthesia represents an important and unalterable part of its treatment. Good knowledge of such pathology, properly performed preoperative preparation, surgery and anaesthesia give the opportunity angiofibroma to be removed safely.