Transantral sphenopalatine artery ligation

M.D., M.P.H. George T. Simpson Ii; Janfaza, Parviz; Becker, Gary D.

doi:10.1288/00005537-198209000-00009

Cited by 36 publications

(19 citation statements)

References 4 publications

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“…One patient of the six failed to respond to initial attempts to cauterize the bleeding site. At the surgeon's discretion, further mtrana¬ sal attempts were halted and the internal maxillary artery Accepted for publication April 6,1992. From the Department of Otolaryngology\p=n-\Headand Neck Surgery, University of Washington, Seattle.…”

Section: Resultsmentioning

confidence: 99%

Rigid Endoscopy for the Control of Epistaxis

O'Leary-Stickney

Makielski

Weymuller

1992

Archives of Otolaryngology - Head and Neck Surgery

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Section: Resultsmentioning

confidence: 99%

Rigid Endoscopy for the Control of Epistaxis

O'Leary-Stickney

Makielski

Weymuller

1992

Archives of Otolaryngology - Head and Neck Surgery

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“…The posterior nasal cavity is supplied mainly via the sphenopalatine artery and greater palatine artery, both of which are terminal branches of the IMAX. This means that the management of posterior epistaxis largely hinges on control of the sphenopalatine artery, 23 and explains the equally high rate of success of ipsilateral IMAX embolisation alone. However, there is still a failure rate of 10 -15% for both embolisation and IMAX/sphenopalatine ligation.…”

mentioning

confidence: 99%

Endovascular treatment of intractable epistaxis - results of a 4-year local audit

et al. 2004

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A total of 57 endovascular embolisation procedures were performed for intractable epistaxis in 51 patients over a 4-year period at the Unitas Interventional Unit near Pretoria. Long-term follow-up was possible in 36 patients. Three cases were due to trauma and 2 directly related to previous facial surgery, 1 patient had hereditary haemorrhagic telangiectasia (HHT), and the remaining 45 cases (88.2%) were classed as idiopathic. Eight patients (15.7%) had a rebleed between 1 and 33 days after the initial embolisation. Four were re-embolised once, 1 was re-embolised twice (the HHT patient), and 2 underwent additional ethmoid artery ligation (with no further bleeding). This gives a primary short-term success rate (in all 51 cases) of 86.3% and a secondary assisted success rate of 94.1% for embolisation alone. Long-term follow-up was obtained in 36 patients, with 35 (97.2%) reporting no further bleeding after the initial procedure(s). Only the patient with HHT developed multiple recurrent bleeds. The mortality rate was 0%, the major morbidity rate 2% (1 stroke), and the minor morbidity rate 25% (N = 36), which included transient facial pain, headaches and femoral problems related to access. Our results compare favourably with other published series. In conclusion, endovascular embolisation for intractable epistaxis is available locally as an alternative technique for the treatment of this difficult condition. IntroductionEpistaxis is a common condition, affecting an estimated 60% of the general population of whom an estimated 6% will seek or require medical assistance.1 Refractory or intractable epistaxis is defined as recurrent or persistent bleeding after appropriate conservative treatment, or multiple episodes of epistaxis over a short period of time, each requiring medical attention.2 Intractable epistaxis usually arises from the posterior or superior parts of the nasal cavity, and is therefore not readily controllable by direct pressure, topical cauterisation or anterior nasal packing. Arterial ligation has remained the mainstay of treatment for intractable posterior epistaxis in many centres.3-6 Percutaneous embolisation of the internal maxillary artery for nasal haemorrhage was first described by Sokoloff et al. in 1974. 7 Several other reports describing the efficacy of endovascular embolisation followed. [8][9][10][11] Currently, endovascular embolisation is an accepted method of treatment for haemorrhage from the nasal cavity or other craniofacial lesions . 12,13 Materials and methodsA retrospective audit was done of 57 percutaneous endovascular embolisation procedures in 51 patients performed over the 4-year period July 1999 -June 2003 at the Unitas Interventional Unit in Centurion. All patients were referred by an otorhinolaryngologist after failed conventional treatment, generally involving local cauterisation and/or nasal packing; 12 patients had also received a blood transfusion prior to embolisation. We reviewed our procedural data notes, with further clinical data obtained either from init...

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“…Portmann et al (1982), ao acessarem o nervo vidiano, sob visibilização microscópica endonasal, relatam que o FEP é encontrado a aproximadamente 12mm superior e lateralmente à borda superior da coana. Simpson et al (1982), após a dissecção de 30 maxilas e a realização de 14 ligaduras da artéria maxilar via transantral, referem que o FEP encontra-se no terço posterior da concha nasal média. Stamm et al (1985Stamm et al ( , 1998 Lateralmente ao forame encontra-se a fossa pterigopalatina.…”

Section: Em Dissecção Cirúrgica Sob Visibilização Microscópicaunclassified

“…As artérias nasal posterior lateral e septal posterior podem ser encontradas separadamente já na fossa pterigopalatina, antes de atravessarem o FEP, ou se dividirem após a passagem pelo mesmo, na cavidade nasal (Pearson et al, 1968;Simpson et al, 1982;Schwartzbauer et al, 2003). A freqüência com que essas ramificações aparecem não está bem estabelecida (Schwartzbauer et al, 2003), e podem variar de um a dez ramos (Pearson et al, 1968;Ram et al, 2000;Lee et al, 2002;Babin et al, 2003;Schwartzbauer et al, 2003;Simmen et al, 2006).…”

Section: Número De Ramos Arteriais Emergentes Pelo Forame Esfenopalatinounclassified

“…A artéria esfenopalatina é um ramo terminal da terceira porção da artéria maxilar e emite ramos arteriais denominados artérias nasais posteriores laterais e ramos septais posteriores (Nomina Anatômica, 1987;Terminologia Anatômica, 2001). Esses vasos são responsáveis pela maior parte do fluxo sangüíneo da região posterior nasal (Simpson et al, 1982;Schwartzbauer et al, 2003). Na literatura, essas artérias são nominadas diferentemente por cada autor, o que pode ser motivo de confusão (Anexo A, Quadro 1) .…”

Section: Introductionunclassified

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Estudo da anatomia da região do forame esfenopalatino na parede lateral do nariz através da dissecção endoscópica em cadáveres

Pádua¹

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Estudo da anatomia da região do forame esfenopalatino na parede lateral do nariz através da dissecção endoscópica em cadáveresINTRODUÇÃO: Apesar do índice de sucesso da cirurgia da ligadura ou cauterização da artéria esfenopalatina, para o tratamento da epistaxe severa, ser maior que 95%, a falha pode variar de 2% a 10%. Algumas variações anatômicas na parede lateral do nariz são relatadas, sendo referentes à localização do forame esfenopalatino (FEP), à presença de um forame acessório, à ramificação das artérias e à dimensão e morfologia do FEP. A variação anatômica dessa região assim como a escassez de estudos endoscópicos mostrando pontos de reparo para o encontro da artéria esfenopalatina e seus ramos podem justificar a falha cirúrgica em alguns casos, assim como a dificuldade técnica encontrada por alguns autores. OBJETIVO: Descrever a anatomia da região do FEP na parede lateral do nariz e as possíveis variações anatômicas, durante a dissecção endoscópica em cadáveres, e observar as possíveis diferenças entre os achados anatômicos, o gênero (masculino/feminino) e o grupo étnico/racial, assim como a simetria entre as fossas nasais. INTRODUCTION:Even though the success rate of sphenopalatine ligation is greater than 95%, some authors have reported some difficulties in isolating those arteries during endoscopic surgical procedure. The failure rate of the sphenopalatine artery ligation or cauterization may vary from 2% to 10%. Some anatomical variations on the nose lateral wall are reported, with reference to the sphenopalatine foramen (SPF) location, the presence of an accessory foramen, arteries ramification and SPF dimension and morphology. Anatomical variation of the region, as well as scarcity of endoscopic studies showing landmarks to find the sphenopalatine artery and its branches may justify surgical failure. OBJECTIVE: The purpose of this study was to describe the anatomy of SPF region and possible anatomical variations, during the endoscopic cadaver dissection and to observe the symmetry between nasal sides and the relationship to gender and racial group. CASUISTICS AND METHODS: It is a prospective anatomical study developed from September, 2006 to January, 2007. The SPF of 61 fresh cadavers (122 nasal fossae) was carefully endoscopic dissected. Male (75%) and mixed race cadavers prevailed. Presence of ethmoidal crest, location of sphenopalatine and accessory foramens, number of arterial branches emerging through foramens and distances from the foramens to anterior nasal spine were observed. Data were analyzed in relation to gender, racial group and symmetry of the same cadaver. Prediction of the presence of accessory foramen was evaluated in relation to number of arterial branches emerging through SPF, SPF location and distance from the SPF to the anterior nasal spine. RESULTS: Ethmoidal crest was present in 100% of cadavers, being anterior to the SPF in 98.4% of times. The most frequent SPF location was the transition region of middle and superior meatus (86.9%). Mean distance from SPF and accessor...

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Transantral sphenopalatine artery ligation

Cited by 36 publications

References 4 publications

Rigid Endoscopy for the Control of Epistaxis

Rigid Endoscopy for the Control of Epistaxis

Endovascular treatment of intractable epistaxis - results of a 4-year local audit

Estudo da anatomia da região do forame esfenopalatino na parede lateral do nariz através da dissecção endoscópica em cadáveres

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