Endoscopic Sphenopalatine Artery Ligation in Posterior Epistaxis

Abstract

Introduction: Posterior epistaxis brings us with a more challenging condition that can even threaten the life of a patient. Approaching the posterior nasal cavity is not an easy task because of its anatomical complexity and impending vision by turbinate. Increase endoscopic anatomic details of lateral nasal wall and endoscopic expertise with high definition camera leads to a higher success rate of endoscopic sphenopalatine artery ligation.Methods: This prospective study was conducted in patients with refractory posterior epistaxis between January 2017 to December 2019. All patient who had undergone Endoscopic Sphenopalatine artery ligation were included in this study. The site of bleeding was confirmed with the help of a rigid endoscope. Bipolar cauterization or clipping was performed to stop bleeding. Data analysis was done by using SPSS 26.0 version.Results: Twenty nine patients who had undergone Endoscopic sphenopalatine artery for posterior epistaxis were included during this study period. The mean age of the patient was 53.31 ± 18.65years. The site of bleeding was mostly from the left in 20 (75.9%) cases and 10 (34.4%) cases had severe bleeding that needed a blood transfusion. No recurrence of bleeding was found during follow up period. The severity of bleeding was significantly correlated with the age of patients (p<0.003). Out of 29 patient, 27 patients had undergone bipolar diathermy and 2 patients clipping was done.Conclusion: Sphenopalatine artery ligation is an effective management strategy for surgical control of refractory epistaxis. The early timing of sphenopalatine artery ligation may lead to reductions in length of stay.

Concha bullosa mucocele disguising as a nasal tumor in an epistaxis patient: A case report

“…Traditional posterior nasal packing was tried but it was not successful. In such cases, bleeding should be controlled with sphenopalatine artery (SPA) ligation that gives very satisfactory result 13 but access to the posterior part of the nose is difficult due to obstructed DNS and Right-sided CB mucocele in this case. It is important to excise the concha bullosa mucocele, open the left nasal cavity by doing endoscopic septoplasty and ligate the bleeding branch i.e.…”