Abstract
Intractable posterior epistaxis remains a challenging problem for our specialty Conventional management options in the form of anterior and posterior packing, arterial ligation of the internal maxillary or the external carotid artery and embolization, are not entively satisfactory because of morbidity, high failure rates, and occasional significant complication. Our experience with endoscopic sphenopalatine artery ligation for four patients with posterior existaxis is described. All patients had epistaxis refractory to anterior and posterior nasal packing, which was rapidly controlled following the procedure. The technique of spheno-palatine artery ligation is described. The technique is simple and effective and prevents the morbidity and complications of nasal packing. It is especially useful in systemically compromised individuals who otherwise tolerate nasal packing poorly. and should be one of the treatment options to be considered relatively early in the management of epistaxis refractory to anterior & posterior nasal packing.
Full Text
The Full Text of this article is available as a PDF (134.8 KB).
References
- 1.Elwany S., Kamel T., Mekhamer A. Pneumatic nasal catheters: advantages and drawbacks. J Laryngol Otol. 1986;100:641–7. doi: 10.1017/S0022215100099837. [DOI] [PubMed] [Google Scholar]
- 2.McDonald T., Pearson BW. Follow up on maxillary artery ligation for epistaxis. Arch Otolaryngol. 1980;106:635–8. doi: 10.1001/archotol.1980.00790340043011. [DOI] [PubMed] [Google Scholar]
- 3.Schaitkin B., Strauss M., Houck JR. Epistaxis: medical versus surgical therapy, a comparison of efficacy complications and economic considerations. Laryngoscope. 1987;97:1392–5. doi: 10.1288/00005537-198712000-00003. [DOI] [PubMed] [Google Scholar]
- 4.Shaw CB, Wax MK, Wetmore SJ. Epistaxis a comparison of treatment. Otolaryngol Head Neck Surg. 1993;109:60–5. doi: 10.1177/019459989310900111. [DOI] [PubMed] [Google Scholar]
- 5.Spafford P., Durham JS. Epistaxis: efficacy of arterial ligation and long term outcome. J Otolaryngol. 1992;21:252–6. [PubMed] [Google Scholar]
- 6.Siniluoto TM, Leinonen AS, Kartunnen AK. Embolisation for management of posterior epistaxis. Arch Otolaryngol. 1993;119:837–41. doi: 10.1001/archotol.1993.01880200037005. [DOI] [PubMed] [Google Scholar]
- 7.Metson R., Hanson DG. Bilateral facial nerve paralysis following arterial embolisation for epistaxis. Otolaryngol Head and Neck Surg. 1983;91:299–302. doi: 10.1177/019459988309100318. [DOI] [PubMed] [Google Scholar]
- 8.Prades J. Microciugia endonasal de la Fossa Pterygomacilary del Meato Medio. Barcelona Spain: Salvet Editores; 1980. [Google Scholar]
- 9.Sharp HR., Rowe-Jones JM., Biring GS., Mackay IS. Endoscopic ligation or diathermy of the sphenopalatine artery in persistant epistaxis. J Laryngol Otol. 1997;111:1047–50. doi: 10.1017/s0022215100139301. [DOI] [PubMed] [Google Scholar]
- 10.Pritkin JB., Calearelli DD., Panje WR. Endoscopic ligation of the internal maxillary artery for treatment of intractable posterior epistaxis. Annal Otol Rhinol Laryngol. 1998;107:85–91. doi: 10.1177/000348949810700201. [DOI] [PubMed] [Google Scholar]
- 11.Srinivasan V., Sheraman IW., Sullivan G. Surgical Management of intractable epistaxis audit of results. J Laryngol Otol. 2000;114:697–697. doi: 10.1258/0022215001906732. [DOI] [PubMed] [Google Scholar]