Resection of the ethmoidal crest in sphenopalatine artery surgery

Neto, Paulo Saraceni; Nunes, Leonardo Mendes Acatauassu; Caparroz, Fábio de Azevedo; Gregório, Luciano Lobato; Souza, Rafael; Simões, Juliana Caminha; Kosugi, Eduardo Macoto

doi:10.1002/alr.21832

Cited by 8 publications

(2 citation statements)

References 24 publications

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“…To decrease the risk of re-bleeding, Saraceni et al [ 23 ] recommend the resection of the ethmoidal crest during the surgical procedure. This provides better exposure to the SPA, allowing a more precise cauterization of all branches.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Sphenopalatine Artery Cauterization in the Management of Recurrent Posterior Epistaxis

et al. 2023

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Background and Objectives: Endoscopic sphenopalatine artery cauterization (ESPAC) has become a reliable and effective surgical procedure for managing posterior epistaxis. The objectives of our study were to evaluate the effectiveness of ESPAC in the management of posterior epistaxis and the possible factors that lead to the failure of the procedure. Materials and Methods: We performed a retrospective analysis of all patients who underwent ESPAC between 2018 and 2022. We retrospectively reviewed the demographic data, patients’ co-morbidities, medical treatment conditions, whether other surgical procedures were performed in addition to the ESPAC, and the success rate of ESPAC. Results: 28 patients were included in our study. After ESPAC, epistaxis was successfully managed in 25 patients (89.28%). Of all patients undergoing ESPAC, three (10.7%) presented re-bleeding. In two patients, we performed an endoscopic revision surgery with re-cauterization of the sphenopalatine foramen area, together with anterior and posterior ethmoidectomy, followed by fat occlusion/obliteration of these sinuses. In one patient, fat obliteration of the anterior and posterior ethmoid was also unsuccessful, and we performed an external carotid artery ligation at the level of the neck with no recurrence afterwards. Conclusions: Endoscopic cauterization of the sphenopalatine artery remains a safe, effective, and reliable surgical procedure in the management of recurrent posterior epistaxis. The use of anticoagulant drugs and the association of hypertension and other heart and liver diseases do not materialize as factors influencing surgical failure.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Sphenopalatine Artery Cauterization in the Management of Recurrent Posterior Epistaxis

et al. 2023

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“…Sphenopalatine artery endoscopic cauterization is currently the most commonly performed surgical procedure for severe epistaxis, and the use of endoscopes has allowed the surgical technique refinement to increase procedural efficacy. 5 , 9 The popularization of nasal endoscopy has encouraged the active search for the bleeding point, previously restricted to the Kiesselbach's plexus, now with the possibility of identifying posterior bleeding points in the nasal cavity. Therefore, nasal endoscopy has resulted in an important change in paradigm regarding the treatment of severe epistaxis.…”

Section: Discussionmentioning

confidence: 99%