Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular tumour. On angiography, it derives its primary blood supply from:

• A Bilateral sphenopalatine artery and internal maxillary artery branches from the external carotid artery ✓
• B Branches of the internal carotid artery via the ophthalmic artery
• C The ascending pharyngeal artery from the external carotid artery
• D The facial artery branches to the posterolateral nasopharynx

Explanation

JNA originates near the sphenopalatine foramen and derives its primary blood supply predominantly from the internal maxillary artery (via sphenopalatine, descending palatine, and posterior nasal branches) on the ipsilateral side, with secondary supply from the ascending pharyngeal and contralateral internal maxillary artery in larger tumours. Preoperative embolisation of the feeding vessels (ECA branches, particularly the internal maxillary artery) 24–48 hours before surgery reduces intraoperative haemorrhage. The ICA may provide supply in advanced tumours with skull base invasion.

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

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Written and medically reviewed by the StethoPrep medical team.