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.
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:
As the growth gets bigger, a child also may have:
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.
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:
A juvenile nasopharyngeal angiofibroma may be hard to treat if it grows into the bone separating the back of the nose from the brain and into the sinuses or eye sockets (orbits).
A team of specialists works together to treat the tumor. The team may include experts in:
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 surgery).
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.
Reviewed by: William J. Parkes, IV, MD
Date Reviewed: Jul 1, 2019
