Endoscopic endonasal surgery for nasopharyngeal angiofibroma

Introduction. The treatment of nasopharyngeal angiofibroma (NAF) is surgical. Various approaches have been described, but due to its lower morbidity and the use of magnification and angled views, the endoscopic-assisted endonasal technique is the most commonly used. The likelihood of achieving complete resection is similar to or better than that of external approaches. Objectives. To describe the clinical, endoscopic, and imaging outcomes of endonasal endoscopic surgery for nasopharyngeal angiofibroma, evaluated in terms of overall local control and tumor stage. Population and methods. A descriptive, retrospective study that included patients treated for NAF using an endonasal approach with endoscopes between March 2012 and November 2024. Results. Eighteen patients were included. The Radkowski staging of the NAFs was as follows: stage I-A: 1; I-B: 3; II-A: 3; II-B: 1; II-C: 4; III-A: 3; and III-B: 3. Three of the 18 patients underwent reoperation due to the presence of residual tumor, using the same endonasal approach (21 endonasal approaches with endoscopes). Conclusion. The overall local control achieved in patients treated for NAF via an endonasal endoscopic approach was 72.22%; local control by stage was as follows: I-A: 1/1, I-B: 3/3, II-A: 3/3, II-B: 1/1, III-A: 1/3, and III-B: 0/3. Complete resolution of nasal obstruction and epistaxis was achieved in all patients. In none of the cases did we need to switch to an external approach due to difficulties with visualization or exposure.