Prospective Study of Complications and its Management in Various Approaches of Juvenile Nasopharyngeal Angiofibroma

Background: Juvenile Nasopharyngeal Angiofibroma (JNA) is a rare, benign but aggressive tumor predominantly affecting adolescent males, leading to significant morbidity.This study evaluated JNA patients' clinical presentation, surgical methods, complications, and recurrence rates.Methods: A prospective study was conducted at Gauhati Medical College and Hospital, involving 14 male patients aged 11 to 25 years undergoing surgery for JNA.Preoperative assessments included CT angiography and MRI scans, with staging using Radkowski and Fisch systems.Data on clinical presentation, surgical approach, complications, and recurrence were collected.Results: The most common stages were Fisch stage II (42.8%) and Radkowski stage IB (35.7%).The endoscopic transnasal approach was the most frequently used surgical method (57.14%), but also had the highest complication rate, including significant intraoperative hemorrhage and nasal crusting (78.57%).Preoperative embolization was performed in all cases to reduce intraoperative bleeding.The recurrence rate was 28.57%, with the endoscopic transnasal approach having the highest recurrence (37.5%). Conclusion:Managing JNA involves balancing tumor exposure and minimizing complications.The endoscopic transnasal approach, despite being common, is linked with higher recurrence and complication rates.Proper patient selection and meticulous surgical technique are crucial to reducing these risks.A tailored surgical approach, considering the tumor's stage and the patient's condition, along with a multidisciplinary approach, is essential for optimal outcomes.