Head and neck tumours: preoperative embolisation of angiofibroma: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Head and neck tumours: preoperative embolisation of angiofibroma

Sample item

A 15-year-old boy with a juvenile nasopharyngeal angiofibroma is scheduled for endoscopic excision. Which preoperative measure reduces intraoperative blood loss?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Angiographic embolisation of the feeding vessels

Juvenile angiofibroma is a highly vascular tumour supplied mainly by the internal maxillary artery. Embolising the feeders 24 to 48 hours before surgery significantly lowers blood loss. Biopsy is avoided because of the risk of severe haemorrhage and the diagnosis is made on imaging.

Option by option

  • A. Incisional biopsy to confirm the diagnosis

    Biopsy risks torrential haemorrhage and is not needed when imaging is characteristic.

  • B. Angiographic embolisation of the feeding vessels (correct)

    Correct. Embolisation of the feeding vessels shortly before surgery reduces bleeding.

  • C. Two weeks of systemic corticosteroids

    Corticosteroids do not shrink this tumour or reduce its vascularity.

  • D. Intravenous bevacizumab infusion

    Bevacizumab is not a standard preoperative measure for angiofibroma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Angiographic embolisation of the feeding vessels. Juvenile angiofibroma is a highly vascular tumour supplied mainly by the internal maxillary artery.

Why is "Incisional biopsy to confirm the diagnosis" not the answer?

Biopsy risks torrential haemorrhage and is not needed when imaging is characteristic.

Why is "Two weeks of systemic corticosteroids" not the answer?

Corticosteroids do not shrink this tumour or reduce its vascularity.

Why is "Intravenous bevacizumab infusion" not the answer?

Bevacizumab is not a standard preoperative measure for angiofibroma.

What concept does this question test?

It tests Head and neck tumours: preoperative embolisation of angiofibroma in ENT. Embolising the feeders 24 to 48 hours before surgery significantly lowers blood loss. Biopsy is avoided because of the risk of severe haemorrhage and the diagnosis is made on imaging.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck tumours: preoperative embolisation of angiofibroma?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.