Publication:

Surgical removal of angiofibroma under hypotensive anesthesia: a retrospective report

Background Juvenile nasopharyngeal angiofibroma (JNA) is a vascular tumor where surgical excision is often complicated by significant intraoperative hemorrhage. While preoperative embolization can reduce bleeding, it is not always available. Induced hypotension is an alternative technique to minimize blood loss.

Methods We conducted a retrospective review of 62 patients who underwent surgical resection of JNA (without intracranial extension) from March 2010 to December 2025. Patients were divided into three groups: group I (normotensive anaesthesia, n=21), group II (hypotensive anaesthesia induced with propofol and halothane, n=21), and group III (hypotension induced with intravenous nitroglycerine infusion, n=20). The primary outcome measured was intraoperative blood transfusion requirements.

Results The mean intraoperative blood transfusion requirement was lower in the hypotensive groups (3.2 units in group I vs approximately 1.75 units in groups II and III).

Conclusions Induced hypotensive anaesthesia was associated with lower reported intraoperative blood transfusion requirements and can be used safely as an alternative to preoperative embolization during surgical resection of JNA.