Role of selective intralesional embolization in vascular conditions of the nose and paranasal sinuses

Anil S. Harugop, Suhasini ., Shama Bellad, Navin Mulimani, Adarsh Sanikop, Jahnavi .


Background: Preoperative angiographic embolization of major feeding vessels is performed for vascular tumours and has become a valuable, even necessary tool in the surgical treatment of vascular lesions and is likely to improve the results of subsequent surgery.

Methods: We have treated six patients, all males, aged between 16-22 years. The patients were informed of the treatment strategy, and their interventions were carried out in accordance with local and general ethical standards and principles. All patients presented with nasal obstruction and epistaxis. Routine blood investigations were done and contrast enhanced CT was done to all patients to know the site of origin, size and extend of the tumour. Five patients were treated with preoperative embolization, whilst one underwent surgery without embolization.

Results: The outcome of the surgery in six patients were evaluated and interpreted. Patients who underwent sub selective embolization (SSE) had lowest morbidity and blood loss when compared to the one operated without embolization.

Conclusions: Embolization has a vital role to play in many aspects of otolaryngological practice. Using this safe technique of SSE, we achieved a significant shortening of time for surgical removal of the tumour as well as a reduction of total perioperative blood loss.


Juvenile nasopharyngeal angiofibroma, Epistaxis, Sub selective embolization, PVA particles

Full Text:



Rosch J, Dotter CT, Brown MJ. Selective arterial embolisation: a new method for control of acute gastrointestinal bleeding. Radiol. 1972;102(2):303-6.

Sokoloff J, Wickbom I, McDonald D, Brahme F, Goergen TG, Goldberger LE. Therapeutic percutaneous embolization in intractable epistaxis. Radiol. 1974;111(2):285-7.

Kingsley D, O’Connor AF. Embolization in otolaryngology. J Laryngol Otol. 1982;96(5):439-50.

Elden L, Montanera W, Terbrugge K, Willinsky R, Lasjaunias P, Charles D. Angiographic embolization for the treatment of epistaxis: a review of 108 cases. Otolaryngol Head Neck Surg. 1994;111:44–50.

Yiotakis I, Eleftheriadou A, Davilis D, Giotakis E, Ferekidou E, Korres S, et al. Juvenile nasopharyngeal angiofibroma stages I and II: a comparative study of surgical approaches. Int J Pediatr Otorhinolaryngol. 2008;72(6):793-800.

Fukutsuji K, Nishiike S, Aihara T, Uno M, Harada T, Gyoten M, et al. Superselective angiographic embolization for intractable epistaxis. Acta Otolaryngol. 2008;128(5):556-60.

Viducich RA, Blanda MP, Gerson LW. Posterior epistaxis: clinical features and acute complications. Ann Emerg Med. 1995;25(5):592-6.

Santaolalla F, Araluce I, Zabala A, Lopez A, Garay M, Sanchez JM. Efficacy of selective percutaneous embolization for the treatment of intractable posterior epistaxis and juvenile nasopharyngeal angiofibroma (JNA). Acta Otolaryngol 2009;129(12):1456-62.

Siniluoto TM, Luotonen JP, Tikkakoski TA, Leinonen AS, Jokinen KE. Value of pre-operative embolization in surgery for nasopharyngeal angiofibroma. J Laryngol Otol. 1993;107(6):514-21.