Endoscopic Sphenopalatine Artery Ligation in Posterior Epistaxis: Retrospective Analysis of 30 Patients

Abstract

Objective: Although posterior epistaxis is rarely seen, it is an important medical problem that both decreases the quality of life of the patient and causes difficulties in the management for otorhinolaryngologists. In this study, we aimed to present the results of 30 patients who underwent transnasal endoscopic sphenopalatine artery ligation (TESPAL) for posterior epistaxis in our department. Methods:The records of 30 patients who underwent TESPAL from January 2014 to April 2016 were analyzed retrospectively, and the relationship between perioperative factors and need for revision surgery was assessed. Results:The success rate of TESPAL in posterior epistaxis was 90%. There was no relationship between surgical failure and antiaggregant use (p=0.224), anticoagulant use (p=0.534), hypertension (p=0.564), previous nasal surgery (p=0.279), and bilateral TESPAL application (p=0.279). TESPAL was seen to be effective in cases with Osler-Weber-Rendu disease, pregnancy, and uncontrollable epistaxis after rhinoplasty surgery. Mortality was seen in one of our patients not related to endoscopic ligation in the follow-up period. Conclusion:TESPAL is an effective method in the treatment of posterior epistaxis. Hypertension, antiaggregant or anticoagulant use, bilateral sphenopalatine artery ligation, and previous nasal surgery do not seem to be factors leading to surgical failure.

Success Rate of Endoscopic Sphenopalatine Artery Ligation for the Management of Refractory Posterior Epistaxis Patients in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

“…Male predominance was seen in patients undergoing ESPAL in our study which was similar to study done by Ismi O, et al 10 Ibrahim, et al 8 Bijaya K et al 6 Pramanik and Adhikari 11 revealed O positive group as the most predominant (35.5%) and AB group as the least prevailing group among Nepalese population which was similar to our study where O positive blood group was found to be predominant 65.85%.…”

Geriatric epistaxis: Management of epistaxis in the geriatric patient group

“…In Yüksel's [13] study, 80.3% of the patients had comorbidities, with the most common comorbidity being HT. In 30 disease studies conducted by Ismi, [6] the prevalence of HT was 56.6%. The prevalence of HT in patients with epistaxis varies between 24 and 64%.…”

“…Although posterior nasal tampons may be used in patients with posterior epistaxis, in recent years, both the morbidity rates and hospitalization duration of these patients have decreased due to the use of transnasal endoscopic sphenopalatine artery ligation (TESPAL) and arterial embolization. [6] While individuals aged over 70 are at a higher risk of epistaxis, they are three times more likely to receive medical care for epistaxis than pediatric patients. [7] Our aim is to define additional features of epistaxis patients in the geriatric population and to have an administrative idea.…”

Comparative Study between Transnasal Endoscopic Sphenopalatine Artery Ligation and Cauterization in Posterior Epistaxis

“…The overall success rate of SPA cauterization was 87.1% which comes in agreement with this study. İsmi et al [15] conduct retrospective analysis of 30 patients with endoscopic sphenopalatine artery ligation in posterior epistaxis. The overall success rate of SPA ligation was 90% which comes in agreement with this study Saraceni et al [9] perform 11 years of follow-up of 98 patients submitted to SPA surgery for epistaxis.…”