Transcaruncular electrocoagulation of anterior ethmoidal artery for the treatment of severe epistaxis

Morera, Eduardo; Artigas, Christian; Trobat, Francisca; Ferrén, Luis; Tomás, Manuel

doi:10.1002/lary.21372

Cited by 15 publications

(6 citation statements)

References 14 publications

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“…The dissection is deep to the lacrimal pathway, and wide exposure of medical orbital wall is obtained. The main drawbacks of the Lynch technique are a visible scar in an area prone to web formation and the risk of telecanthus, ectropion and permanent epiphora . Other risks are direct orbital trauma, cerebrospinal fluid leak and amaurosis.…”

Section: Discussionmentioning

confidence: 99%

Pre‐caruncular approach to the medial orbit and landmarks for anterior ethmoidal artery ligation: a cadaveric study

Cornelis

Lubbe

2016

Clinical Otolaryngology

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Section: Discussionmentioning

confidence: 99%

Pre‐caruncular approach to the medial orbit and landmarks for anterior ethmoidal artery ligation: a cadaveric study

Cornelis

Lubbe

2016

Clinical Otolaryngology

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“…7 When the olfactory groove meningiomas reach a giant size, there are occasionally branches from the ACAs and anterior communicating arteries that are also supplying them. 7,25,32 The AEA is an orbital branch of the third segment of the ophthalmic artery and runs between the superior oblique and medial rectus muscles before leaving the orbit at the anterior ethmoidal foramen, together with the anterior ethmoidal nerve, to enter the roof of the ethmoidal sinus. It crosses the cribriform plate and enters the nose through a tiny slit adjacent to the crista galli to become the dorsal nasal artery, and also enters the cranial cavity near the cribriform plate to supply the dura mater of the anterior cranial fossa and the anterior part of the falx cerebri.…”

Section: Discussionmentioning

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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“…In case of repeated failure or if a new bleed arises after removing of the packing, a rigid nasal endoscopy is performed in general anesthesia and all branches of the sphenopalatine artery are coagulated and transected. If the bleeding persists or the source of bleeding is clearly located in the supply area of the ethmoidal arteries, external closure is performed by lynch incision or transcaruncular approach [16]. …”

Section: Methodsmentioning

confidence: 99%

THREAT helps to identify epistaxis patients requiring blood transfusions

Murer

Ahmad

Roth

et al. 2013

Journal of Otolaryngology - Head & Neck Surgery

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ObjectiveTo analyze the characteristics of patients who needed a blood transfusion due to epistaxis-caused anemia and to define potential risk factors.DesignRetrospective cohort study.SettingA total cohort of 591 epistaxis patients, prospectively included between March 2007 and April 2008 at the ENT department of the University Hospital of Zurich, was evaluated concerning the need for blood transfusions.MethodsThe clinical charts and medical histories of these patients were evaluated.Main outcome measuresCommon parameters that increase the risk for severe anemia due to epistaxis.ResultsTwenty-two patients required blood transfusions due to their medical condition. 22.7% suffered from traumatic nosebleeds. Another 27.3% had a known medical condition with an increased bleeding tendency. These proportions were significantly higher than in the group of patients without need of blood transfusion. The odds ratio for receiving a blood transfusion was 14.0 in patients with hematologic disorders, 4.3 in traumatic epistaxis and 7.7 in posterior bleeders. The transfusion-dependent epistaxis patients suffered significantly more often from severe posterior nosebleeds with the need for a surgical therapeutic approach.ConclusionsPatients with severe nosebleeds either from the posterior part of the nose or with known hematologic disorders or traumatic epistaxis should be closely monitored by blood parameter analyses to evaluate the indication for hemotransfusion. The acronym THREAT (Trauma, Hematologic disorder, and REAr origin of bleeding → Transfusion) helps to remember and identify the factors associated with an increased risk of receiving blood transfusion.

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Transcaruncular electrocoagulation of anterior ethmoidal artery for the treatment of severe epistaxis

Abstract: Transcaruncular electrocoagulation of the anterior ethmoidal artery is a safe and effective technique to deal with upper third nasal fossa bleeding.

Cited by 15 publications

References 14 publications

Pre‐caruncular approach to the medial orbit and landmarks for anterior ethmoidal artery ligation: a cadaveric study

Pre‐caruncular approach to the medial orbit and landmarks for anterior ethmoidal artery ligation: a cadaveric study

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

THREAT helps to identify epistaxis patients requiring blood transfusions

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