Abstract
Juvenile nasopharyngeal angiofibroma is a rare and highly vascular tumor that affects adolescent males. Although histologically benign, its locally aggressive growth and propensity for significant bleeding make surgical management challenging. Endoscopic techniques have increasingly become the preferred treatment approach. To evaluate the outcomes of endoscopic surgical treatment using extended medial maxillectomy with wide exposure of the pterygopalatine fossa and to assess factors potentially associated with recurrence in pediatric patients with JNA. A retrospective study was performed including pediatric patients treated for JNA between 2020 and 2026. Clinical presentation, imaging findings, tumor stage, operative details, complications, and follow-up outcomes were reviewed. All patients underwent preoperative embolization followed by an endoscopic extended medial maxillectomy approach. Eight male patients with a mean age of 15.3 years were included. Complete endoscopic resection was achieved in all cases. Postoperative complications occurred in three patients. Follow-up ranged from 2 to 6 years. No residual or recurrent disease was detected. Endoscopic transnasal resection combined with preoperative embolization provides excellent tumor control in pediatric patients. Wide exposure of the pterygopalatine fossa and drilling of tumor attachment sites may facilitate complete resection and minimize the risk of recurrence.