Juvenile nasopharyngeal angiofibroma (JNA) is a histologically benign but locally aggressive vascular tumour. Its characteristic presentation, hormonal predisposition, and the primary feeding vessel are:

• A Occurs in post-menopausal females; fed by the posterior ethmoidal artery
• B Occurs in adolescent males; arises from the sphenopalatine foramen region; primarily fed by the internal maxillary artery (sphenopalatine branch) ✓
• C Occurs in elderly males; arises from the pterygoid process; fed by the ascending pharyngeal artery
• D Occurs in children under 5 years; no hormonal dependency; multiple feeding vessels equally

Explanation

JNA occurs almost exclusively in adolescent males (peak 14–25 years), reflecting its androgen (testosterone) receptor expression and growth stimulus at puberty. The primary site of origin is the posterior nasal cavity at the sphenopalatine foramen / posterior wall of the nasal cavity adjacent to the superior margin of the sphenopalatine foramen. The primary blood supply is the internal maxillary artery via the sphenopalatine branch. Pre-operative embolisation (typically 24–48 hours before surgery) reduces intraoperative blood loss. FESS or open approaches are used depending on Radkowski staging.

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

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Written and medically reviewed by the StethoPrep medical team.