{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:58:11Z","timestamp":1790974691416,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review explores the natural history of residual and recurrent juvenile nasopharyngeal angiofibromas (JNAs) to inform clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Embase, Scopus, and Web of Science.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>A systematic literature review was conducted according to PRISMA guidelines across PubMed, Embase, Scopus, and Web of Science from inception to February 20, 2025 and was re\u2010run on September 21, 2025. Studies included patients with advanced JNA and documented follow\u2010up of residual or recurrent disease. Descriptive statistics, chi\u2010squared analysis, and analysis of variance were used to evaluate treatment outcomes across different modalities including surgery, radiotherapy, gamma knife surgery, and medical therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010one studies encompassing 131 male patients (mean age 16.3\u2009years) were included. Residual or recurrent disease demonstrated complete involution in 41%, stable disease in 29%, and reduction in size in 25% of cases. Only 2% of patients had progressive disease. A statistically significant association was observed between treatment modality and outcome (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), with radiotherapy, either alone, or as part of a multimodal approach, showing the highest rates of spontaneous involution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Residual and recurrent JNAs often remain stable or regress without further intervention. Close surveillance with imaging is a safe and effective strategy for asymptomatic patients, minimizing the risks of additional treatment in a young patient population with disease near critical anatomical structures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70634","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T03:48:31Z","timestamp":1779680911000},"page":"4130-4138","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Natural History of Residual and Recurrent Disease in Advanced Juvenile Nasopharyngeal Angiofibroma: A Systematic Review"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3902-3771","authenticated-orcid":false,"given":"Shivani Angelique","family":"Kumar","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Health and Human Sciences Macquarie University  Macquarie Park New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Petocz","sequence":"additional","affiliation":[{"name":"Graduate Research Academy Macquarie University  Macquarie Park New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6512-3613","authenticated-orcid":false,"given":"Raewyn G.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Health and Human Sciences Macquarie University  Macquarie Park New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.9.1071"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21767"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.22947"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.176.1.2162070"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000298905.71259.BB"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhino15.104"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1608658"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23760"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2006.05.004"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(199708)19:5<391::AID-HED5>3.0.CO;2-V"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24522"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198904000-00013"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198711000-00014"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348948409300408"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1996.01890140012004"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2890030404"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40779-020-00238-8"},{"key":"e_1_2_12_19_1","unstructured":"R.RyanandS.Hill \u201cHow to GRADE the Quality of the Evidence \u201dCochrane Consumers and Communication Group 2016 http:\/\/cccrg.cochrane.org\/author\u2010resources."},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6890"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(89)90157-0"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(93)90017-P"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0936-6555(98)80091-5"},{"issue":"3","key":"e_1_2_12_24_1","first-page":"172","article-title":"Long\u2010Term Results of Radiation Therapy for Juvenile Nasopharyngeal Angiofibroma","volume":"22","author":"Reddy K. 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