MyMedR

Fulltext Endoscopic cauterization of the sphenopalatine artery in persistent epistaxis

Harvinder S, Rosalind S, Gurdeep S

Med J Malaysia, 2008 Dec;63(5):377-8.

PMID: 19803294 MyJurnal

The management of epistaxis remains to be a challenging problem for most ENT surgeon especially posterior epistaxis. Most cases are managed by placement of posterior nasal packs or balloons and failure leads to more invasive techniques, involving ligation of the internal maxillary artery. The above management is associated with significant patient complication and morbidity. Endoscopic ligation or cauterization of the sphenopalatine artery has emerged as a viable and minimally invasive alternative. We have performed endoscopic cauterization of nine sphenopalatine arteries in eight patients with no further episodes of epistaxis and complications, with an average follow-up of 25 months. The mean age of the patients was 52.75 years. Fifty percent of the patients had a history of hypertension.

Matched MeSH terms: Epistaxis/surgery*

Fulltext Intractable epistaxis secondary to a post-traumatic pseudoaneurysm

Mann GS, Philip R, Balachandran A

Med J Malaysia, 2005 Aug;60(3):367-9.

PMID: 16379195

Epistaxis is a common problem encountered in clinical practice. It is usually self-limiting and is usually controlled with conservative measures such as nasal compression or ice-packs. Occasionally nasal packing is required. It is rarely severe enough that surgical intervention is warranted. The following report illustrates a patient who presented to us with a rare cause of life-threatening epistaxis that is, a post-traumatic pseudoaneurysm who finally required surgical intervention to control the bleeding.

Matched MeSH terms: Epistaxis/surgery

Nasal closure for severe hereditary haemorrhagic telangiectasia in 100 patients. The Lund modification of the Young's procedure: a 22-year experience

Lund VJ, Darby Y, Rimmer J, Amin M, Husain S

Rhinology, 2017 Jun 01;55(2):135-141.

PMID: 28064338 DOI: 10.4193/Rhin16.315

INTRODUCTION: Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant vascular disease characterized by recurrent epistaxis, mucocutaneous telangiectasia and visceral arteriovenous malformations. The nosebleeds can be life-threatening and in these circumstances, radical treatment is required.

METHODS: Since 1994, closure of the nose has been undertaken to prevent severe nasal bleeding in patients meeting specific selection criteria. Outcome data collected on this cohort pre- and post-operatively is available for analysis.

RESULTS: From a cohort of 515 HHT patients, 100 have undergone nasal closure, bilateral ab initio in 81%. Fifty patients completed pre- and post-operative epistaxis severity questionnaires and provided information on post-operative problems and 28 completed a Glasgow Benefit Inventory (GBI). Overall most patients derived significant benefit from the procedure with complete cessation of nasal bleeding in 94%, a highly significant improvement in the epistaxis score and a mean GBI score of 53.4. Loss of smell and taste was the most frequent post-operative complaint.

CONCLUSION: HHT can be associated with life-threatening epistaxis significantly affecting patients quality of life. Permanent prevention of airflow is associated with complete or near-total cessation of epistaxis in the majority of patients.

Matched MeSH terms: Epistaxis/surgery*

Massive epistaxis from traumatic aneurysm of the internal carotid artery

Saim L, Rejab E, Hamzah M, Sakijan S, Selvapragasam T

Aust N Z J Surg, 1993 Nov;63(11):906-10.

PMID: 8216074

Intracavernous carotid artery aneurysm following head injury is a rare occurrence. Two such cases presenting with delayed but massive and repeated epistaxis are reported and the literature reviewed. The first case required a trapping procedure while the second case had only cervical carotid ligation to control the bleeding. Both resulted in no neurological sequelae.

Matched MeSH terms: Epistaxis/surgery

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