Endoscopic assisted external approach anterior ethmoidal artery ligation for the management of epistaxis

Douglas, Suzanne; Gupta, Divya

doi:10.1258/002221503762624594

Cited by 35 publications

(17 citation statements)

References 4 publications

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“…Because all patients underwent concomitant endoscopic sphenopalatine and AEA ligation, it is unclear which of these procedures was responsible for the successful control of epistaxis. Embolization of the internal maxillary artery and endoscopic sphenopalatine artery ligation alone both have reported success rates of 85% to 98% for the treatment of patients with “posterior” epistaxis 2,3,6,10,11–13 Patients who rebleed after such procedures, however, frequently undergo ligation of the anterior ethmoid artery with subsequent control of epistaxis 11 . Several authors suggest including ligation of the anterior ethmoid artery in the treatment of patients with refractory epistaxis and no clearly identifiable posterior source of bleeding 4,12 .…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ligation of the Anterior Ethmoid Artery

Pletcher

Metson

2007

The Laryngoscope

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Section: Discussionmentioning

confidence: 99%

Endoscopic Ligation of the Anterior Ethmoid Artery

Pletcher

Metson

2007

The Laryngoscope

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“…This helped in the stoppage of the bleeding in many cases. There are many other methods that can be applied for the treatment of these cases, like lasers [11,13,14], cryotherapy, endoscopic ligation of the sphenopalatine artery [15], and endoscopic ligation of the ethmoidal arteries [15,16]. As these facilities were not available in our hospital, the above mentioned procedures were not done.…”

mentioning

confidence: 99%

Rigid Nasal Endoscopy in the Diagnosis and Treatment of Epistaxis

Kumar

Prasad²,

Gowda³

2013

JCDR

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Background and Objectives: Epistaxis is one of the common symptoms encountered in the Otorhinolaryngology department. Many times the cause for epistaxis is not found on anterior and posterior rhinoscopy. The present study was undertaken to assess the role of rigid nasal endoscope in the diagnosis and treatment of epistaxis, where normal anterior and posterior rhinoscopy did not reveal any specific finding.Methods: Fifty patients with epistaxis were studied using rigid nasal endoscope under local anaesthesia. Patients who were above 15 years with nasal bleeding and who were willing for rigid nasal endoscopy were included in the study. Patients less than 15 years were not included in the study because nasal endoscopy was difficult in them under local anaesthesia. Only those patients in whom, the cause for epistaxis could not be made out on anterior and posterior rhinoscopy were chosen for the study, this was done in order to remove the bias for nasal endoscopy. Results:The use of the nasal endoscope allowed diagnosis of bleeding points and treating them directly. Epistaxis was more in male patients especially in the 3 rd and after the 5 th decade. On endoscopic examination,the bleeding points were identified as coming from the crevices of the lateral nasal wall, posterior spur on the septum, posterior deviation of the septum with ulcer, congested polyps, enlarged and congested adenoids, scabs or crusts in the crevices of the lateral nasal wall and angiofibroma. Endoscope also helps in the treatment of epistaxis, which includes endoscopic selective nasal packing using gelfoam, endoscopic cautery or diathermy and endoscopic polypectomy. Other patients with adenoids, scabs and crusts and angiofibroma were managed on their merits. Interpretation and Conclusion:Nasal endoscopy helps not only in the localisation of the bleeding point but also in the treatment of those bleeding areas that are situated in the posterior and lateral part of the nose.

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“…9 The transcaruncular approach avoids the risk of a facial scar and has gained popularity for the ligation of the AEA 32,38 (Fig. 5).…”

Section: 44mentioning

confidence: 99%

Extracranial ligation of ethmoidal arteries before resection of giant olfactory groove or planum sphenoidale meningiomas: 3 illustrative cases with a review of the literature on surgical techniques

Manjila¹,

Cox²,

Smith³

et al. 2013

FOC

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Object There are several surgical techniques for reducing blood loss—open surgical and endoscopic—prior to resection of giant anterior skull base meningiomas, especially when preoperative embolization is risky or not technically feasible. The authors present examples of an institutional experience using surgical ligation of the anterior and posterior ethmoidal arteries producing persistent tumor blush in partially embolized tumors. Methods The authors identified 12 patients who underwent extracranial surgical ligation of ethmoidal arteries through either a transcaruncular or a Lynch approach. Of these, 3 patients had giant olfactory groove or planum sphenoidale meningiomas. After approval from the institution privacy officer, the authors studied the medical records and imaging data of these 3 patients, with special attention to surgical technique and outcome. The variations of ethmoidal artery foramina pertaining to this surgical approach were studied using preserved human skulls from the Hamann-Todd Osteological Collection at the Museum of Natural History, Cleveland, Ohio. Results The extracranial ligation was performed successfully for control of the ethmoidal arteries prior to resection of hypervascular giant anterior skull base meningiomas. The surgical anatomy and landmarks for ethmoidal arteries were reviewed in anthropology specimens and available literature with reference to described surgical techniques. Conclusions Extracranial surgical ligation of anterior, and often posterior, ethmoidal arteries prior to resection of large olfactory groove or planum sphenoidale meningiomas provides a safe and feasible option for control of these vessels prior to either open or endoscopic resection of nonembolized or partially embolized tumors.

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Endoscopic assisted external approach anterior ethmoidal artery ligation for the management of epistaxis

Cited by 35 publications

References 4 publications

Endoscopic Ligation of the Anterior Ethmoid Artery

Endoscopic Ligation of the Anterior Ethmoid Artery

Rigid Nasal Endoscopy in the Diagnosis and Treatment of Epistaxis

Extracranial ligation of ethmoidal arteries before resection of giant olfactory groove or planum sphenoidale meningiomas: 3 illustrative cases with a review of the literature on surgical techniques

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