title: Endoscopic sphenopalatine artery ligation is an effective method of treatment for posterior epistaxis.
abstract: Transantral ligation of the internal maxillary artery is the most widely used surgical technique for control of intractable epistaxis. Although this technique is highly efficacious, significant complications may occur, including oroantral fistula, damage to the infraorbital nerve, and recurrent bleeding. An endoscopic transnasal approach for ligation of the terminal branch of the internal maxillary artery, the sphenopalatine artery, provides an alternative to transantral ligation. We have used endoscopic ligation of the sphenopalatine artery to treat 38 patients requiring surgical therapy for epistaxis. These cases were retrospectively reviewed to analyze the efficacy and morbidity of our technique. Five patients (13%) had significant recurrence of their epistaxis, of whom two required further surgical intervention. There were no major complications in this series. There were some minor sequelae including nasal crusting (34%) and paresthesia of the palate and nose (13%). The median hospital stay was 3 days (range 1 to 10). Endoscopic transnasal sphenopalatine artery ligation seems to be a safe and effective technique for management of posterior epistaxis.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Snyderman
authors.forename: S A
authors.initials: SA
authors.lastname: Goldman
authors.forename: R L
authors.initials: RL
authors.lastname: Carrau
authors.forename: B J
authors.initials: BJ
authors.lastname: Ferguson
authors.forename: J R
authors.initials: JR
authors.lastname: Grandis
mesh_terms: D000368:Aged; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D004844:Epistaxis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000009:adverse effects / Q000379:methods; D008297:Male; D008438:Maxillary Artery / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010159:Palate / Q000098:blood supply; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000098:blood supply; D016896:Treatment Outcome