Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization

Janakiram T N; Mansi A R Venkatramanan; Soumya Sampath; Arunkumar G; Bavaharan Rajalingam

doi:10.5152/ejra.2024.24135

Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization

Abstract

Objective: Juvenile Nasopharyngeal Angiofibroma (JNA) is a benign, yet locally aggressive tumor with a rich blood supply. Surgical management is the mainstay treatment for JNA, however, blood loss is a big concern during surgery. This retrospective study aims to evaluate the efficacy of ligating the feeding vessels of JNA based on preoperative imaging, potentially eliminating the need for preoperative embolization. Methods: We retrospectively analyzed the medical records of 380 patients who underwent surgery for JNA at our tertiary care, high volume center, without prior embolization. Preoperative scans were reviewed to identify the location of feeding vessels. Surgical techniques were adapted to ligate the major feeding vessel(s) identified preoperatively. Intraoperative blood loss was meticulously recorded. Results: In the 380 patients, the mean blood loss increased with advancing disease stage. The average blood loss across all stages was 635.54 mL. This observed blood loss was significantly lower compared to data published by other studies that employed preoperative embolization for blood loss reduction. Conclusion: Preoperative evaluation of imaging for feeding vessel localization accurately correlated with intraoperative findings. Ligation of identified feeding vessels might eliminate the need for preoperative embolization in JNA surgery.

Keywords

References

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Details

Primary Language

English

Subjects

Otorhinolaryngology

Journal Section

Research Article

Authors

Janakiram T N
0000-0002-7904-0835
India

Mansi A R Venkatramanan This is me
0000-0002-4423-5026
India

Soumya Sampath This is me
0009-0005-4233-3473
India

Arunkumar G This is me
0009-0000-5704-9794
India

Bavaharan Rajalingam This is me
0009-0001-5191-6313
India

Publication Date

May 13, 2024

Submission Date

April 13, 2024

Acceptance Date

April 19, 2024

Published in Issue

Year 2024 Volume: 7 Number: 1

DOI

https://doi.org/10.5152/ejra.2024.24135

IZ

https://izlik.org/JA24DH99MC

Cite

RIS / Bibtex

APA

T N, J., Venkatramanan, M. A. R., Sampath, S., G, A., & Rajalingam, B. (2024). Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization. European Journal of Rhinology and Allergy, 7(1), 8-13. https://doi.org/10.5152/ejra.2024.24135

AMA

1.T N J, Venkatramanan MAR, Sampath S, G A, Rajalingam B. Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization. Eur J Rhinol Allergy. 2024;7(1):8-13. doi:10.5152/ejra.2024.24135

Chicago

T N, Janakiram, Mansi A R Venkatramanan, Soumya Sampath, Arunkumar G, and Bavaharan Rajalingam. 2024. “Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization”. European Journal of Rhinology and Allergy 7 (1): 8-13. https://doi.org/10.5152/ejra.2024.24135.

EndNote

T N J, Venkatramanan MAR, Sampath S, G A, Rajalingam B (May 1, 2024) Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization. European Journal of Rhinology and Allergy 7 1 8–13.

IEEE

[1]J. T N, M. A. R. Venkatramanan, S. Sampath, A. G, and B. Rajalingam, “Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization”, Eur J Rhinol Allergy, vol. 7, no. 1, pp. 8–13, May 2024, doi: 10.5152/ejra.2024.24135.

ISNAD

T N, Janakiram - Venkatramanan, Mansi A R - Sampath, Soumya - G, Arunkumar - Rajalingam, Bavaharan. “Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization”. European Journal of Rhinology and Allergy 7/1 (May 1, 2024): 8-13. https://doi.org/10.5152/ejra.2024.24135.

JAMA

1.T N J, Venkatramanan MAR, Sampath S, G A, Rajalingam B. Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization. Eur J Rhinol Allergy. 2024;7:8–13.

MLA

T N, Janakiram, et al. “Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization”. European Journal of Rhinology and Allergy, vol. 7, no. 1, May 2024, pp. 8-13, doi:10.5152/ejra.2024.24135.

Vancouver

1.Janakiram T N, Mansi A R Venkatramanan, Soumya Sampath, Arunkumar G, Bavaharan Rajalingam. Targeted Approach to Ligation of Feeding Vessels Based on Preoperative Imaging in Resection of Juvenile Nasopharyngeal Angiofibroma Obviating Preoperative Embolization. Eur J Rhinol Allergy. 2024 May 1;7(1):8-13. doi:10.5152/ejra.2024.24135