Perioperative Management of Juvenile Nasopharyngeal Angiofibroma: A Retrospective Analysis of 56 Patients From a Single Tertiary Care Institute, AANA Journal, October 2016

www.aana.com/aanajournalonline The present study was undertaken with the primary aim to analyze a large number of surgically treated patients with juvenile nasopharyngeal angiofibroma (JNA) in respect to preoperative embolization, different surgical procedures, and JNA stages. Ages of the patients ranged between 8 and 31 years. Mean blood loss was 1,240 mL (range, 50-6,000 mL). Preoperative embolization was performed in 23 patients (41%). Mean blood loss in patients who underwent embolization was not significantly different from those who did not; 1,580.4 mL vs 910.4 mL. Mean blood loss in stage IIB and above was more than 1 L. Intraoperatively 15 patients (37%) required 2 U of packed red blood cells. Postoperatively only 22 patients (39%) required packed red blood cells compared with 38 (67%) intraoperatively. The trachea was kept electively intubated in 46 patients (82%). We conclude that most of the JNA surgeries do not require replacement of more than 2 U of blood intraoperatively. Only 1 intravenous line is required in stages IB and IIA because of less blood loss. Not all patients need to be kept intubated electively in the postoperative period.