Flexible laser Sphenopalatine artery ligation: An alternative to the classic approach

Karkos, Petros D.; Stavrakas, Marios

doi:10.1111/coa.13498

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…Related to technical advances, Karkos and Stavrakas [ 36 ] recently reported the use of a flexible 980 nm diode laser fiber to coagulate the SPA branches in cases when access to the nose was difficult secondary to unfavorable anatomy (septal spurs and narrow nasal cavities).…”

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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“…47 Recently a group from Greece described the technique of a flexible diode-laser SPA ligation as an alternative to the classic approach (clips or diathermy). 48 Flexible 980 nm Diode laser fiber was used through a nasal or laryngeal handpiece in a nearcontact mode to the SPA at energy of 5 to 7 W for 5 seconds in a CW where access to the SPA area was limited due to septal spurs, very narrow nose, or significant bleeding. Surgical time was kept under 60 minutes and there were no reports of rebleed or other complications.…”

Section: Sphenopalatine Artery Ligationmentioning

confidence: 99%

Lasers in Rhinology—An Update

2020

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Objectives: A wide and evolving range of lasers and their applications often makes it difficult for a busy surgeon to choose the ideal laser for a specific indication. With this in mind, this article aims to summarize the most recent literature concerning laser application in rhinology. Methods: A literature search from 2000 to 2020 using the PubMed database was employed. Keywords used included “laser,” “rhinology,” “endonasal endoscopic surgery,” “hereditary haemorrhagic telangiectasia,” “rhinitis,” “refractory rhinitis,” “Inferior turbinate hypertrophy,” “dacryocystorhinostomy,” “septoplasty,” “cartilage reshaping” and “choanal atresia.” The most up to date studies published for each rhinology condition that could potentially be treated with laser surgery was included. Results: Rhinological conditions appropriate for laser applications are discussed. We identified articles related to a number of applications including hereditary hemorrhagic telangiectasia, rhinitis, turbinate surgery, dacryocystorhinostomy, septoplasty, choanal atresia, and sphenopalatine artery ligation, paying attention to the outcomes of the studies and their limitations. Conclusions: There is currently no one-size-fits-all laser and therefore being up to date on the latest clinical application results can help the clinician decide which are the best treatments to offer their patients.

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Epistaxis: Surgical Management

Stavrakas

2021

Rhinology and Anterior Skull Base Surgery

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Flexible laser Sphenopalatine artery ligation: An alternative to the classic approach

Cited by 3 publications

References 3 publications

Endoscopic Sphenopalatine Artery Cauterization in the Management of Recurrent Posterior Epistaxis

Endoscopic Sphenopalatine Artery Cauterization in the Management of Recurrent Posterior Epistaxis

Lasers in Rhinology—An Update

Epistaxis: Surgical Management

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