{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T22:53:21Z","timestamp":1778712801612,"version":"3.51.4"},"reference-count":23,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,1,4]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>A juvenile nasopharyngeal angiofibroma (JNA) is a benign vascular tumour that arises from the pterygopalatine fossa. It is seen near exclusively in young males though female cases have been reported. Symptoms are due to their high vascularity and mass effect. Commonly reported symptoms include: nasal obstruction, epistaxis and nasal discharge. The mainstay of treatment is surgical resection either via an endonasal endoscopic approach or open surgical resection. Preoperative embolisation has been shown to decrease intraoperative bleeding. Embolisation may be undertaken via a transarterial (TA) approach or, more recently, via direct tumorous puncture (DTP). Options for recurrent or residual disease may include revision surgery, radiotherapy or close clinical surveillance. The following case presentation describes the management of a recurrent JNA in an adult male using preoperative embolisation via a combination of TA and DTP embolisation and an open surgical resection via a subtemporal-preauricular infratemporal fossa approach.<\/jats:p>","DOI":"10.1136\/bcr-2022-252862","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T09:46:32Z","timestamp":1673516792000},"page":"e252862","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Management of a recurrent right juvenile nasopharyngeal angiofibroma using direct tumorous puncture embolisation and a subtemporal-preauricular infratemporal fossa surgical approach"],"prefix":"10.1136","volume":"16","author":[{"given":"Stefan","family":"Linton","sequence":"first","affiliation":[{"name":"Otolaryngology, Manchester Royal Infirmary, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Navin","family":"Mani","sequence":"additional","affiliation":[{"name":"ENT, Manchester Royal Infirmary, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Stockley","sequence":"additional","affiliation":[{"name":"Interventional Radiology, Salford Royal Hospitals NHS Foundation Trust, Salford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Pathmanaban","sequence":"additional","affiliation":[{"name":"Neurosurgery, Salford Royal NHS Foundation Trust, Salford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"key":"2025082710241983000_16.1.e252862.1","doi-asserted-by":"crossref","DOI":"10.1001\/jama.1940.02810350009004","article-title":"Fibromas of the nasopharynx","volume":"115","author":"Figi","year":"1940","journal-title":"J Am Med Assoc"},{"key":"2025082710241983000_16.1.e252862.2","doi-asserted-by":"crossref","first-page":"32","DOI":"10.5005\/jp-journals-10001-1334","article-title":"Current management and controversies of juvenile angiofibromas","volume":"9","author":"Butler","year":"2018","journal-title":"Int J Head Neck Surg"},{"key":"2025082710241983000_16.1.e252862.3","doi-asserted-by":"publisher","DOI":"10.1080\/00016480600818138"},{"key":"2025082710241983000_16.1.e252862.4","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200104000-00022"},{"key":"2025082710241983000_16.1.e252862.5","first-page":"702-704","article-title":"Nasopharyngeal angiofibroma in an elderly female patient: a rare case report","volume":"9","author":"Ralli","year":"2018","journal-title":"Mol Clin Oncol"},{"key":"2025082710241983000_16.1.e252862.6","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1965.00760010631014"},{"key":"2025082710241983000_16.1.e252862.7","first-page":"1122","article-title":"Expression of androgen receptors in nasopharyngeal angiofibroma: an immunohistochemical study of 24 cases","volume":"11","author":"Hwang","year":"1998","journal-title":"Mod Pathol"},{"key":"2025082710241983000_16.1.e252862.8","doi-asserted-by":"crossref","first-page":"51","DOI":"10.3109\/00016489.2014.952774","article-title":"Hormonal receptors and vascular endothelial growth factor in juvenile nasopharyngeal angiofibroma: immunohistochemical and tissue microarray analysis","volume":"135","author":"Liu","year":"2015","journal-title":"Acta Otolaryngol"},{"key":"2025082710241983000_16.1.e252862.9","unstructured":"Flood LM . 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