Anesthetic Considerations in the Resection of Juvenile Nasopharyngeal Angiofibroma at a Tertiary Care Hospital in the Yucatan Peninsula: A Case Report

This article delineates the anesthetic management of an adult patient diagnosed with Juvenile Nasopharyngeal Angiofibroma (JNA) undergoing surgical resection at a tertiary care facility. The discussion highlights critical perioperative challenges, specifically advanced airway management and the maintenance of hemodynamic stability. Juvenile Nasopharyngeal Angiofibroma (JNA) represents a benign hypervascular, and infrequent neoplasm occurring almost exclusively in adolescent males (1),(2). Notwithstanding its benign histology, it may turn aggressive due to its capacity for local invasion of adjacent anatomical structures (2). The vascular supply is derived primarily from the internal maxillary artery, which accounts for its high degree of vascularity and the significant risk of intraoperative hemorrhage (2). Clinically, JNA typically presents with unilateral nasal obstruction, recurrent epistaxis, and, in advanced stages, mass-effect secondary symptoms such as exophthalmos or facial dysmorphism (2). It is noteworthy that, as massive hemorrhage constitutes one of the primary complications in the context of these neoplasms, anesthetic considerations are of paramount importance, representing a formidable challenge for the anesthesiologist (3). It is concluded that preoperative embolization and permissive hypotension are efficacious modalities to mitigate the morbidity and mortality associated with the surgical resection of JNA; these techniques yielded favorable outcomes in the present clinical case, which demonstrated a satisfactory trans-anesthetic and postoperative clinical course.