Angiofibroma (JNA) preoperative embolisation is typically performed 24–72 hours before surgery. The most common major complication of endovascular embolisation in this setting is:

• A Permanent facial palsy
• B Non-target embolisation causing retinal artery occlusion or cranial nerve ischaemia ✓
• C Tumour volume increase after embolisation
• D Anaphylaxis to contrast agent

Explanation

Non-target embolisation is the most feared complication of preoperative embolisation of JNA. Because the tumour's blood supply (internal maxillary artery / sphenopalatine artery branches) may have anastomoses with the ophthalmic artery (via ethmoidal branches) or cranial nerve vasa nervorum, inadvertent embolisation can cause retinal artery occlusion (blindness) or cranial nerve ischaemic palsies. Careful angiographic mapping and superselective catheterisation are essential. The procedure significantly reduces intraoperative blood loss.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.