{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T13:09:12Z","timestamp":1774444152867,"version":"3.50.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T00:00:00Z","timestamp":1716163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Standard treatment of a juvenile angiofibroma (JNA) is surgical resection, usually with an endoscopic endonasal surgery and a preoperative embolization. However, standard intra-arterial embolization may fail to completely devascularize tumors. A novel technique of direct intranasal intratumoral onyx embolization has been described. The aim of this study is to demonstrate the safety and the usefulness of this embolization technique on a pediatric case of JNA and to compare our results to previously reported cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case:<\/jats:title>\n                    <jats:p>A twelve-year-old patient suffering from Von Willebrand disease presented with a voluminous JNA with intracranial extension. Internal carotid artery (ICA) branches partially vascularized the tumor. The patient had two previous incomplete surgical resections, which were preceded by a standard embolization, due to massive perioperative bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>A direct intratumoral embolization of onyx safely allowed complete tumoral devascularization. Tumoral resection was then completed by an endonasal endoscopic approach. Surgery time was decreased (4,5 h versus 5,5 and 6,5 h) and blood loss were minimized (300 ml versus 1 l and 1,3 l). No complication occurred. Twelve articles previously reported this embolization technique. We present the first reported case of onyx embolization being used for a pediatric patient with a coagulation disorder and a voluminous tumor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A direct intratumoral onyx embolization allowed complete resection of a massive JNA, for a patient with Von Willebrand disease. Our data suggest that this technique is safe and may be instrumental for a JNA's resection, even if little vascularization comes from ICA branches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.109784","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T23:05:58Z","timestamp":1716419158000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Direct tumoral puncture embolization of onyx before endoscopic endonasal resection of a massive juvenile angiofibroma for a patient with Von Willebrand disease - A case report and review of literature"],"prefix":"10.1097","volume":"120","author":[{"given":"Laura-Elisabeth","family":"Gosselin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, Universit\u00e9 Laval, 2325 rue de l'Universit\u00e9, Quebec City, Quebec G1V 0A6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre-Olivier","family":"Champagne","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CHU de Qu\u00e9bec-Universit\u00e9 Laval, Pavillon Enfant-J\u00e9sus, 1401 18e rue, Quebec City, Quebec G1J 1Z4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascale","family":"Lavoie","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CHU de Qu\u00e9bec-Universit\u00e9 Laval, Pavillon Enfant-J\u00e9sus, 1401 18e rue, Quebec City, Quebec G1J 1Z4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvie","family":"Nadeau","sequence":"additional","affiliation":[{"name":"Departement of Otolaryngology, CHU de Qu\u00e9bec-Universit\u00e9 Laval, Pavillon Enfant-J\u00e9sus, 1401 18e rue, Quebec City, Quebec G1J 1Z4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"1","key":"R1-16-20260325","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1055\/s-0037-1615810","article-title":"Juvenile Angiofibroma: current management strategies","volume":"79","author":"Safadi,","year":"2018","journal-title":"J. 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