Endoscopic Surgery of Juvenile Angiofibroma

Surgery is considered the gold standard for the treatment of juvenile angiofibroma (JA), and preoperative embolization has provided significant reduction of complications and intraoperative bleeding with minimal risk of residual disease. The advent of endoscopic surgery has revolutionized the management of JA, which was traditionally based on a wide array of external approaches. Endonasal endoscopic resection is currently adopted as a safe and effective technique for the removal of small- and intermediate-sized JAs. Endoscopic removal of large and invasive JAs is feasible even in selected cases but should only be performed by experienced teams with expertise also in external approaches. Recurrent or more appropriately residual lesions are commonly diagnosed within 3 years from surgery.