Pre-Operative Embolization with Direct Onyx Tumoral Puncture Prior to Endoscopic Resection of Massive Juvenile Nasopharyngeal Angiofibroma

Juvenile angiofibromas (JNA) of Fisch Stage 3 and above often take a direct blood supply via the internal carotid artery (ICA) due to skull base involvement. These blood vessels, including the artery of the foramen rotundum and/or the vidian artery, are not easily accessed via traditional embolization methods. Employing a novel technique we can embolize residual vascular areas within these tumors prior to endoscopic resection.