Evaluating the Impact of Intraoperative Magnetic Resonance Imaging on the Resection of Juvenile Nasopharyngeal AngiofibromaEvaluating the impact of intraoperative MRI on the resection of juvenile nasopharyngeal angiofibroma.

BACKGROUND

Complete resection is essential in the management of juvenile nasopharyngeal angiofibroma (JNA), yet residual disease remains a major cause of recurrence, particularly in advanced cases. Intraoperative MRI (IO-MRI) may support intraoperative decision-making, but its clinical utility in JNA surgery remains unclear.

AIMS/

OBJECTIVES

To evaluate the selective role of intraoperative MRI (IO-MRI) in intraoperative decision-making during endoscopic resection of JNA.

MATERIAL AND

METHODS

Nine patients who underwent endoscopic endonasal resection of JNA with IO-MRI assistance were retrospectively reviewed. IO-MRI findings, intraoperative management changes, and follow-up outcomes were evaluated.

RESULTS

IO-MRI detected no residual tumor in seven patients (77.7%). In one case, residual disease identified on IO-MRI prompted additional resection during the same operation. In another case, a residual tumor involving critical neurovascular structures was detected, and further resection was avoided. No recurrence was observed in eight patients during follow-up, and no IO-MRI-related morbidity occurred.

CONCLUSIONS

IO-MRI may serve as a valuable adjunct in JNA surgery by supporting intraoperative decisions to either continue or safely limit resection. Its use appears most beneficial in anatomically complex or advanced-stage tumors.