Specialties & Conditions Juvenile Nasopharyngeal Angiofibroma (JNA)
Juvenile Nasopharyngeal Angiofibroma (JNA)
Program
What Is Juvenile Nasopharyngeal Angiofibroma?
Juvenile nasopharyngeal angiofibroma (JNA) is an aggressive but rare and benign (non-cancerous) tumor of the nasopharynx, the space behind the nose that connects it to the mouth. The tumor is mostly made of blood vessels.
JNAs tend to develop in young men between 10 and 25 years old and can cause recurrent nose bleeds (epistaxis), as well as spread to the sinuses, eye socket, brain, and skull.
What Are the Symptoms of Juvenile Nasopharyngeal Angiofibroma?
Symptoms of JNA include:
- Nasal obstruction (nasal stuffiness)
- Severe or recurring nosebleeds
If it grows large enough, it may cause:
- Change in facial appearance
- Complete obstruction of both sides of the nose
- Facial pain
- Headaches
- Visual disturbances
- Disturbances to a child’s quality of sleep
What Causes Juvenile Nasopharyngeal Angiofibroma?
While it is known that it is not hereditary, the cause of JNAs are not fully known.
How Is Juvenile Nasopharyngeal Angiofibroma Diagnosed?
JNAs are diagnosed by nasal endoscopy performed by an Ear, Nose, & Throat (ENT/Otolaryngologist) specialist or by conventional CT and MRI scans.
MRI (left) and CT (right) views of the head and nose, showing a large mass (juvenile nasopharyngeal angiofibroma) in the back/deep part of the nasal cavity, extending into the back of the throat. The Arrowheads outline the margins of the mass.
Front (left picture) and side (right picture) views of an angiogram showing the extensive blood flow to the JNA (red arrowheads).
How Is Juvenile Nasopharyngeal Angiofibroma Treated?
Surgery is the primary treatment for JNAs. However, since the tumor has abnormally, increased blood flow, an angiogram (a test that uses x-rays and a special dye to see inside the arteries) with embolization (cutting down the blood supply to the JNA) is performed first. This makes the surgery easier, faster and safer.
The embolization limits the flow of blood through the vessels that feed the tumor, helping to limit blood loss during surgery. In some cases, the tumor can be removed with an endoscopic approach through the nostrils. This approach results in an unchanged external appearance, reduced post-surgical pain, and shorter healing times.
JNAs may recur even after surgical or endoscopic removal. As a result, ongoing nasal endoscopic examination and imaging studies are used to monitor the area for recurrence in the years post-surgery. If the tumors return, they are removed in a similar fashion.