Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-18T18:54:45.476Z Has data issue: false hasContentIssue false
  • English
  • Français

Endoscopic devascularisation of sphenopalatine bundle in intractable posterior epistaxis: technique, efficacy and safety

Published online by Cambridge University Press:  26 August 2011

H M Eladl ,
S M Elmorsy  and
Y W Khafagy
H M Eladl*
Affiliation:
Otorhinolaryngology Department, Mansoura University Hospital, Mansoura University, Egypt
S M Elmorsy
Affiliation:
Otorhinolaryngology Department, Mansoura University Hospital, Mansoura University, Egypt
Y W Khafagy
Affiliation:
Otorhinolaryngology Department, Mansoura University Hospital, Mansoura University, Egypt
*
Address for correspondence: Dr Hesham Mohammad Eladl, ORL Department, Mansoura University Hospital, Elgomhoria St, Mansoura, Egypt. PostalCode:35516 E-mail: heshameladl@mans.edu.eg
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To evaluate endoscopic cauterisation of the sphenopalatine neurovascular bundle, as treatment for intractable posterior epistaxis, with regard to efficacy, safety and post-operative sequelae.

Patients and methods:

A prospective study reviewed 42 patients with severe posterior epistaxis who were treated with endoscopic cauterisation of the sphenopalatine neurovascular bundle, over a 17-month period.

Results:

Hypertension and hepatic disease were present as predisposing factors in 66.7 and 35.7 per cent of patients, respectively. Branching of the sphenopalatine artery at its foramen was present in more than 85 per cent of patients. The success rate was 100 per cent, with no recurrent epistaxis in the follow-up period. Severe nasal dryness was present in only four patients (9.5 per cent); hypoaesthesia was found in the nasal mucosa of eight patients, without any patient complaints.

Conclusion:

Endoscopic sphenopalatine neurovascular bundle cauterisation is an effective treatment for refractory posterior epistaxis. In this study, neurovascular bundle cauterisation did not cause any neurological deficits or major complications.

Keywords

EpistaxisSphenopalatine ArteryCauteryMinimally Invasive Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 11 , November 2011 , pp. 1136 - 1140
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Babin, E, Moreau, S, Goullet, deRugy, M, Delmas, P. Anatomic variations of the arteries of the nasal fossa. Otolaryngol Head Neck Surg 2003;128:236–9CrossRefGoogle ScholarPubMed
2von Buchwald, C, Tranum-Jensen, J. Endoscopic sphenopalatine artery ligation or diathermy. Operat Tech Otolaryngol 2006;17:28–30CrossRefGoogle Scholar
3Navarro, J, Filho, J. Anatomy of the maxillary artery in the pterygo-maxillo-palatine fossa. Anat Anz 1982;152:413–33Google ScholarPubMed
4Legent, F, Boutet, JJ, Wesoluch, M, Viale, M, Galiba, J, Beauvillain, C. Surgical treatment of epistaxis. Interest in micro-surgical endo-nasal treatment [in French]. Rev Laryngol 1986;107:31–3Google Scholar
5Bolger, WE, Borgie, RC, Melder, P. The role of the crista ethmoidalis in endoscopic sphenopalatine artery ligation. Am J Rhinol 1999;13:81–6CrossRefGoogle ScholarPubMed
6Orlandi, RR. Endoscopic sphenopalatine artery ligation. Operat Tech Otolaryngol 2001;12:98–100CrossRefGoogle Scholar
7Voegels, RL, de Melo Padua, FG. The endoscopic anatomy of the sphenopalatine foramen. Otolaryngol Head Neck Surg 2007;137(suppl 1):270CrossRefGoogle Scholar
8Voegels, RL, Curti, Thome D, Vasquez, PP, Butugan, O. Endoscopic ligature of the sphenopalatine artery for severe posterior epistaxis. Otolaryngol Head Neck Surg 2001;124:464–7CrossRefGoogle ScholarPubMed
9Barlow, DW, Deleyiannis, FWB, Pinczower, EF. Effectiveness of surgical management of epistaxis at a tertiary care center. Laryngoscope 1997;107:21–4CrossRefGoogle ScholarPubMed
10Budrovich, M, Saetti, R. Microscopic and endoscopic ligature of the sphenopalatine artery. Laryngoscope 1992;102:1391–4CrossRefGoogle ScholarPubMed
11Sharp, HR, Rowe-Jones, JM, Biring, GS, Mackay, IS. Endoscopic ligation or diathermy of the sphenopalatine artery in persistent epistaxis. J Laryngol Otol 1997;111:1047–50CrossRefGoogle ScholarPubMed
12Stojcev, Stajcić L, Gacić, B, Popović, N, Stajcić, Z. Anatomical study of the pterygopalatine fossa pertinent to the maxillary nerve block at the foramen rotundum. Int J Oral Maxillofac Surg 2010;39:493–6CrossRefGoogle Scholar
13Claes, J, Claes, G, Boudewyns, AN, Rombaux, P, Daele, JJ. Endoscopic endonasal ligation in treatment of severe posterior epistaxis. Acta Otorhinolaryngol Belg 2000;54:151–6Google ScholarPubMed
14Snyderman, CH, Goldman, SA, Carrau, RL, Ferguson, BJ, Grandis, JR. Endoscopic sphenopalatine artery ligation is an effective method of treatment for posterior epistaxis. Am J Rhinol 1999;13:137–40CrossRefGoogle ScholarPubMed
15Moorthy, R, Anand, R, Prior, M, Scott, PM. Inferior turbinate necrosis following endoscopic sphenopalatine artery ligation. Otolaryngol Head Neck Surg 2003;129:159–60CrossRefGoogle ScholarPubMed