Abstract
The surgical approach to juvenile nasopharyngeal angiofibroma (JNA) is usually an open approach, such as lateral rhinotomy, midfacial degloving and the transpalatal approach, because of the vascular nature and site of the tumor. We report the case of an 18-year-old male who presented with the right nasal obstruction and repeated epistaxis and was transferred to our hospital with the diagnosis of JNA. Preoperative angiography showed that the external carotid artery was the main feeder of the tumor, with the possibility of partial supply from the internal carotid artery. Therefore, to reduce intraoperative bleeding, we conducted temporary clamping of the external and internal carotid arteries during the operation and clipped the right maximal artery by the transnasal endoscopic approach. One-third of the total septum (posterior) was removed to obtain adequate space for the endoscopic approach. The tumor was jutted pulled? out into the pterygopalatine fossa, and the root of the tumor was determined to be the sphenopalatine artery close to right aperture of the sphenoidal sinus. To achieve complete tumor resection, a navigation system was used that helped us to detect the orientation of the operative field.
