A juvenile nasopharyngeal angiofibroma (JNA) is a growth in the area behind the
nose. These growths are benign (not cancer), but can damage nerves and bones and block
ear and sinus drainage. Almost all JNAs are in teenage boys.
What Are the Signs & Symptoms of a Juvenile Nasopharyngeal Angiofibroma?
Juvenile nasopharyngeal angiofibromas cause symptoms only when they're big enough
to keep air from passing through the nose or press on parts of the nose and sinuses.
A child with a JNA may have:
trouble breathing through the nose
a lot of nosebleeds,
often with blood coming from only one side
a runny nose that doesn't go away after several days
What Causes a Juvenile Nasopharyngeal Angiofibroma?
Doctors don't know for sure what causes a juvenile nasopharyngeal angiofibroma
(nay-zoe-fuh-RIN-jee-uhl an-jee-oh-fye-BROH-muh). But many think the cells that form
the growths are left over from early pregnancy.
How Is a Juvenile Nasopharyngeal Angiofibroma Diagnosed?
Doctors will ask a child about JNA symptoms, such as trouble breathing through
the nose, and do an exam. Sometimes the doctor can see the growth when looking in
the nose or mouth. But most are only visible when the doctor uses a tiny camera (endoscope)
to check inside the nose.
The doctor will send the child to an ear, nose and throat (ENT, also called otolaryngology)
specialist for diagnosis and treatment.
Many kinds of masses can grow behind the nose. So the ENT doctor will do the endoscopy
and other tests such as:
Surgery is usually the first choice for treatment. Sometimes, image-guided treatment
is recommended before surgery to shrink the growth and decrease bleeding during surgery.
In most cases, surgery is done without
any external incisions, using a camera on a thin tube passed into the nose (endoscopic
What Else Should I Know?
Surgeons might not be able to remove all of a juvenile nasopharyngeal angiofibroma
that's grown into the sinuses or the bones in the back of the nose. If this happens,
the JNA might grow back after surgery. Sometimes doctors use radiation
therapy or medicine to slow this growth.
A JNA may grow well into adulthood, so patients need to have imaging studies (CT
or MRI) repeated over time to look for regrowth. Patients will need follow-up with
the care team specialists into early adulthood.
JNAs are almost always found in teenage boys, so scientists are looking for ways
to treat the growths with hormones,
hormone blockers, or other medicines.