International Rhinologic Society Rhinology 0300-0729 2026 06 04 Juvenile nasopharyngeal angiofibroma: nationwide study on incidence, diagnosis, treatment, and recurrence EN M. El Haddouchi Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark P.R.G. Eriksen Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark R.H. Dahl Department of Radiology, Copenhagen University Hospital, Rigshospitalet, Copengagen, Denmark M. Kongsvad Department of Otorhinolaryngology, Odense University Hospital, Odense, Denmark W. Krone Department of Radiology, Odense University Hospital, Odense, Denmark G. Gal Department of Radiology, Odense University Hospital, Odense, Denmark M. Holtmannspoetter Department of Neuroradiology, Nuremberg Hospital, Paracelsus Medical University, Nuremberg, Germany G. Benndorf Department of Radiology, Baylor College of Medicine, Houston, TX, USA G. Lelkaitis Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark C. von Buchwald Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark Journal Article 3440 10.4193/Rhin24.550 BACKGROUND: Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumour affecting adolescent males, originating near the sphenopalatine foramen and often expanding aggressively. This nationwide study examines the clinical presentation, treat-ment, and prognosis of patients diagnosed from 2003 until mid-2022. METHODS: Patients were identified in the national patho-logy database. The Kaplan-Meier estimator calculated event-free survival, and t-test and Fisher's exact test compared variables. The incidence rates were determined using the 2000 World Health Organization World Standard Population. RESULTS: Sixty-one male patients were included (median age: 16.5 years). The national incidence was 0.12 per 100,000 male person-years (0.43 per 100,000 men at risk (10-24 years)). Common symptoms included nasal obstruction (90%) and epistaxis (59%). Predominant tu-mour stages were Radkowski IIB (31.3%) and Chandler III (65%). Most patients (97%) underwent preoperative embolization, with image-guided endoscopic sinus surgery (ESS) as the primary treatment (86%). Median intraoperative blood loss (IBL) was 500 mL. Radkowski staging correlated with IBL, tumour devascularization, and internal carotid artery (ICA) blood supply. No major compli-cations occurred. Recurrence (25%) was associated with Chandler stage III-IV, with a two-year recurrence-free survival rate of 77%. CONCLUSIONS: Tumour stage correlated with IBL, tumour devascularization, and ICA supply. Recurrence mainly occurred within two years post-surgery, exclusively in advanced-stage cases. With close collaboration between interventionists and rhinologists, preoperative embolization followed by image-guided ESS is recommended as a safe approach with minimal risks.