REVIEWS   

Otorinolaringologia 2006 September;56(3):137-43

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

Personal experience with endoscopic management of posterior epistaxis

Durr D. G.

Division of Otolaryngology, Department of Surgery Anna-Laberge Hospital Center Châteauguay, Quebec, Canada

Aim. Recent literature has embraced the use of electrosurgery, sphenopalatine vascular clipping and endoscopy in posterior epistaxis. With the advent of endoscopy the surgical treatment of posterior epistaxis has shifted from internal maxillary ligation to endoscopic sphenopalatine artery (SPA) control. This review introduces my personal experience in an endoscopic electrosurgical approach for patients suffering of idiopathic posterior epistaxis that combines one or more the following methods: endoscopic selective branch cauterization, endoscopic SPA cautery, and endoscopic posterior nasal cauterization. This approach was been used in a hospital-based community otolaryngology practice for over 7 years (1999-2005).
Methods. The data presented in this review are based on my experience in a series of 17 patients treated during a 35-month period (2000-2003), prospectively followed. I will discuss the surgical technique, patients’ outcome and the implications of such practice.
Results. All Seventeen patients underwent endoscopic electrosurgical management of posterior epistaxis. No packing was inserted at the end of all surgeries. All patients had successful recovery after surgery with no recurrence of bleeding. They were discharged the following day; or later in three patients that needed further medical evaluation.