Operative benefits of embolisation in advanced-stage juvenile nasopharyngeal angiofibroma: a meta-analytic comparison.

OBJECTIVES

Juvenile nasopharyngeal angiofibroma is a highly vascular benign tumour affecting adolescent males. Our aim was to compare operative outcomes in embolised and non-embolised patients, with emphasis on tumour stage.

METHODS

A systematic review was conducted using three databases (PubMed, Scopus and Google Scholar) in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.

RESULTS

Overall, 17 studies with a total of 524 patients met the inclusion criteria. The meta-analysis showed a significant difference in estimated blood loss between embolised and non-embolised groups (overall effect size -685 ml; p < 0.001). Additionally, embolised patients with advanced stage tumours tended to lose less blood during surgery than non-embolised patients (mean of 1551.9 ml vs. 4051.5 ml; p = 0.065).

CONCLUSION

This systematic review and meta-analysis demonstrate that pre-operative endovascular embolisation provides an operative advantage in patients undergoing juvenile nasopharyngeal angiofibroma surgical resection. A near-significant trend towards greater benefit in higher-stage tumours was observed (p = 0.065), warranting further prospective investigation.