Percutaneous embolization to control intractable epistaxis in nasopharyngeal carcinoma.
BACKGROUND
Epistaxis in patients with nasopharyngeal carcinoma (NPC) who have received radiotherapy can be difficult to control by conventional methods. The use of angiography and embolization to control problematic epistaxis has been well documented in other situations, but its use in severe or recurrent epistaxis following irradiation for NPC has not been described.


METHODS
We retrospectively reviewed case notes of all patients with NPC initially seen with epistaxis over a 4-year period. Those patients with refractory epistaxis which could not be controlled by conventional methods and required angiography and embolization were assessed.


RESULTS
Eight patients who underwent angiography were identified. Five patients showed hypervascularization and three patients had pseudoaneurysms or an aneurysm of the internal carotid artery seen on the angiogram. All these patients were successfully embolized. There were no significant complications after the procedure.


CONCLUSIONS
We conclude that embolization is a safe and effective method of controlling refractory epistaxis in patients irradiated for NPC.
Mok
J S
JS
Department of Surgery, Division of Otorhinolaryngology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T.
Marshall
J N
JN
Chan
M
M
van Hasselt
C A
CA
D000328:Adult; D000783:Aneurysm / Q000628:therapy; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D004621:Embolization, Therapeutic; D004844:Epistaxis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008438:Maxillary Artery / Q000000981:diagnostic imaging; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000098:blood supply / Q000150:complications* / Q000000981:diagnostic imaging / Q000532:radiotherapy; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome