Surgical treatment of severe epistaxis: an eleven-year experience

Abstract

This study concluded that the surgical treatment for epistaxis, when indicated, had good success rates and low incidence of complications. In our service, it remains as the gold-standard procedure for nosebleeds refractory to initial management measures.

Intraoperative variations of the sphenopalatine artery between epistaxis and non-epistaxis cases: a comparative endoscopic analysis

“…In the same systematic review, the endoscopic ligation and/or cauterization of AEA was described as a common cause of controlling recurrent epistaxis when it was performed either concomitantly with or after SPA cauterization [4]. This observation was again highlighted in similar studies over the past years [1,12,16]. These data clearly signify that the efficient identification of bleeding source during surgical management of severe epistaxis remains challenging in certain cases and probably for some surgeons.…”

“…All three failures required AEA exploration and cauterization with subsequent control of epistaxis, and this means that in those 3 cases, the cause of failure was that the AEA was the source of bleeding in these cases. It was noted in several previous studies that improved control of severe epistaxis occurred when combining SPA/AEA cauterization, and it would reduce the number of theater returns [1,4,5,16,24]. The authors suggest that it may be prudent to control the AEA with the SPA in cases lacking two or more of the following arterial criteria (arterial diameter ≤ 4, adherence to the mucosa of the lower part of the basal lamella, adherence to the mucosa of sphenopalatine nerve bundle).…”

“…The existence of a consensus protocol in the staggered application of surgical treatments of severe epistaxis, aiming at the correct intraoperative identification of the bleeding point, is of vital importance. The lack of a universal management protocol and the difficulty to identify the bleeding source, in most cases of severe epistaxis [1,2], have given rise to many surgical paradigms targeting the empirical ligation and/or cauterization of main feeding blood vessels of the nasal mucosa. The selected surgical paradigm depends mainly upon the surgeon's own experience and his/her expectation for the source of bleeding.…”

The Influence of Seasonal Temperature Variation on Blood Pressure Behavior

“…In Brazil, there have been some studies that associated seasonal temperature variation with gestational hypertension, 4,23 symptoms of stroke, 24,25 respiratory diseases, 26 epistaxis 27 and others that investigated the association between climate and mortality from different diseases in elderly individuals. 28 Only one study 29 approached the subject, when it investigated the effect of water temperature on cardiovascular responses: heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) during exercise at different temperatures (29° C, 33° C and 37° C).…”

Besim Ömer’in Tabib-i Etfal Adlı Eserinde Çocuk Hastalıklarıyla Mücadele Yöntemleri ve Bunların Modern Tıpla Benzerlikleri

“…"The patients seen for epistaxis at our service were submitted to the initial emergency protocol, which included airway and respiratory care, along with hemodynamic stabilization procedures." 17 Today, air humidifiers and various gels are used to stop epistaxis. The most effective of these is the treatment with air humidifier.…”