Surgical management of juvenile XXXX without @entity887 .

@entity1 @entity5 @entity18871 @entity887 @entity954
Juvenile @entity18871 (JNA) is a rare benign neoplasm that occurs almost exclusively in the nasopharynx of adolescent males. Surgery remains the primary treatment of choice. JNA has always presented a management challenge to surgeons because of its vascular nature, site of occurrence, and local tissue destruction. The surgical approaches are either standard open method which include external or intraoral incisions, or the recent advanced approach, i.e. via using the endonasal endoscope. It is widely accepted that the use of preoperative @entity887 reduces the occurrence of @entity954 and @entity5 removal. However, @entity887 is not available at all centres. The purpose of this article is to present our experience with five @entity1 diagnosed with JNA who were resected without embolization, using various surgical approaches. Two @entity5 were removed via endonasal endoscopic surgery. None of the @entity5 were embolized prior to surgery. We highlight the preoperative evaluation of @entity5 extent, using both computed tomography (CT) and magnetic resonance angiography, and the importance of temporary clamping of the external carotid artery intraoperatively. Our results suggest that the latter procedure is a safe and effective means of facilitating surgery and reducing @entity954 .
