Efficacy of selective percutaneous embolization for the treatment of intractable posterior epistaxis and juvenile nasopharyngeal angiofibroma (JNA).
CONCLUSIONS
Percutaneous embolization reduces the reappearance of epistaxis and the mean length of hospital stay for patients with intractable epistaxis or juvenile nasopharyngeal angiofibroma (JNA).


OBJECTIVE
To assess whether percutaneous embolization is effective for the treatment of intractable epistaxis and JNA.


METHODS
Twenty-eight patients with intractable posterior epistaxis treated by embolization (25 males; m = 59.78 years; SD = 14.3) and 28 unembolized patients (24 males; m = 59.21 years; SD = 15.13) were studied retrospectively. Eight patients with JNA (all males; mean = 16.5 years; SD = 2.35; four embolized before surgery and four unembolized) were also analyzed.


RESULTS
Embolization was bilateral in 71.4% of subjects, blood transfusion was required in 28.57%, incidence of complications was 53.57%, and seven of the embolized patients with intractable epistaxis suffered from recurrence of the epistaxis. There were no statistically significant differences between the embolized and unembolized groups. The mean hospital stay was longer in unembolized patients (4.46 days; SD = 2.42) than for the embolized patients (3.78 days; SD = 3.9), p=0.394. The most serious complications occurred in patients embolized with idiopathic epistaxis and the mean post-embolization hospital stay was longer in this subgroup (4.14 days; SD = 4.39) than in patients with Rendu-Osler-Weber syndrome (2.40 days; SD = 1.140), p=0.395. Unembolized patients with JNA presented greater hemorrhage (m = 2025 ml; SD = 325) and a longer mean hospital stay (m = 18 days; SD = 3) than the group of embolized patients (m = 360 ml; SD = 185 and m = 9 days; SD = 1, respectively).
Santaolalla
Francisco
F
Department of Otorhinolaryngology, Basurto Hospital School of Medicine, University of the Basque Country, Bilbao, Spain. francisco.santaolalla@ehu.es
Araluce
Inigo
I
Zabala
Aitor
A
López
Antonio
A
Garay
Miguel
M
Sanchez
Jose Maria
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018322:Angiofibroma / Q000453:epidemiology / Q000628:therapy*; D004621:Embolization, Therapeutic; D004844:Epistaxis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D055815:Young Adult