Preoperative Transarterial Embolization of Advanced Juvenile Nasopharyngeal Angiofibroma Using n-Butyl Cyanoacrylate: Case-control Comparison with Microspheres.

PURPOSE: To evaluate the efficacy and safety of transarterial embolization (TAE) with n-butyl cyanoacrylate (nBCA) for juvenile nasopharyngeal angiofibroma (JNA).

MATERIALS AND METHODS: A retrospective review was performed of JNA patients who underwent TAE and endoscopic resection between 2020 and 2022 at our hospital. Patients embolized with nBCA were identified, and those embolized with microspheres were set as the control group. Data on demographics, symptoms, tumor characteristics, blood loss, adverse events, residual disease, and recurrence were collected, and case-control analysis was performed for the two groups. Differences in characteristics between the groups were tested using Fisher's exact and Wilcoxon tests. A generalized linear model (GLM) was used to analyze the univariate and multivariate influences on blood loss.

RESULTS: Twenty patients were included in this study: 13 in the microsphere group and seven in the nBCA group. The median blood loss was 400 mL (interquartile range [IQR] 200-520 mL) in the nBCA group and 1000 mL (IQR 500-1000 mL) in the microsphere group (P = 0.028). GLM confirmed lower blood loss in the nBCA group (relative risk [RR]: 0.58 [0.41-0.83], P = 0.01). A residual tumor was found in one patient in each group (7.7% vs. 14.3%, P = 1.000). Recurrence was not observed in any patient. None of the patients experienced adverse events during embolization.

CONCLUSION: TAE of advanced JNA with nBCA glue is safe and effective, and it can significantly reduce intraoperative blood loss compared with microspheres.