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We aim to systematically review and synthesize the clinical characteristics, management, and outcomes of ENA-SNT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review adhered to PRISMA guidelines. A literature search was conducted across major databases, including PubMed, EMBASE, Web of Science, and Google Scholar. Articles that reported ENA-SNT cases in humans were eligible for inclusion. Data extraction and quality assessment were independently performed by two reviewers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 145 studies were included, comprising 163 patients. The mean age was 28.8 years (range, 0\u201378), with a male-to-female ratio of 2.1:1. The nasal septum (33.3%), inferior turbinate (16.6%), and maxillary sinus (16.0%) were the most frequent tumor sites. Common symptoms included nasal obstruction (73.0%) and epistaxis (68.1%), often in combination (55.2%). Angiography demonstrated no hypervascularity in 23.1% of cases; when present, the internal maxillary artery supplied the tumor in 96.1%. Preoperative biopsy caused brisk bleeding in 44.5%. Surgery was the primary treatment in 94.4% of cases, with a recurrence rate of 5.3% and an average time to recurrence of 3.8 months. Intracranial and orbital involvement were rare: 1.84% and 2.45%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This review supports ENA-SNT as a clinical entity distinct from juvenile nasopharyngeal angiofibroma. Symptoms develop more rapidly, but the tumor is less aggressive, less vascularized, and has a better prognosis. ENA-SNT can occur across all age groups and in female individuals. Surgical resection is the treatment of choice, with low recurrence rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-025-09985-7","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T21:00:37Z","timestamp":1771275637000},"page":"3447-3472","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Extranasopharyngeal angiofibroma of the sinonasal tract: A systematic review"],"prefix":"10.1007","volume":"283","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0933-1300","authenticated-orcid":false,"given":"Fabio Portella","family":"Gazmenga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3924-0461","authenticated-orcid":false,"given":"Jochen P.","family":"Windfuhr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5351-4158","authenticated-orcid":false,"given":"Fabio","family":"Lau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5294-3698","authenticated-orcid":false,"given":"Mariana D.C.","family":"Toro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5963-912X","authenticated-orcid":false,"given":"Eulalia","family":"Sakano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"issue":"8","key":"9985_CR1","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1288\/00005537-199208000-00014","volume":"102","author":"PJ Gullane","year":"1992","unstructured":"Gullane PJ, Davidson J, O\u2019Dwyer T, Forte V (1992) Juvenile angiofibroma: a review of the literature and a case series report. 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