Sphenopalatine artery ligation: a brief review
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20250801Keywords:
Epistaxis, Endoscopic, Ligation, Sphenopalatine artery, TransnasalAbstract
Nasal bleeds, anterior or posterior necessitate varied stepladder interventions like the simple thumb-index finger pinch technique, insertion of spindle cotton plug or the layered roller gauze, the latex urological Sir Foleys catheter and its fine grade silicone modifications, feeding vessel bipolarization or embolization. The middle turbinate being the line of demarcation between the internal and external carotid supply to the nose. The anterior and posterior ethmoid arteries are the distributaries of the internal carotid system. The former is ligated or fulgurated via the external Howarth or the intranasal endoscopic approach. The sphenopalatine artery is the primary distributary of the external carotid system to the nasal and the paranasal region, which is accessed trans-nasally or trans-antrally and ligated, clipped or fulgurated in uncontrolled epistaxis. Endoscopic visualization facilitates the procedure. The intervention is precise, quick and avoids the uncomfortable sequel of conventional nasal tamponade, like excess nasal crusting, anosmia, cacosmia and cheek paraesthesia.
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Chandler JR, Serrins AJ. Transantral Ligation of the Internal Maxillary Artery for Epistaxis. Laryngos. 1965;75:1151–9. DOI: https://doi.org/10.1288/00005537-196507000-00011
Budrovich R, Saetti E. Microscopic and endoscopic ligature of the sphenopalatine artery. The. 1992;102(12):1390-4. DOI: https://doi.org/10.1288/00005537-199212000-00016
Pothier DD, MacKeith S, Youngs R. Sphenopalatine artery ligation. The J of Laryngol and Otol. 2005;119(10):810-2. DOI: https://doi.org/10.1258/002221505774481354
Feusi B, Holzmann D, Steurer J. Posterior epistaxis: systematic review on the effectiveness of surgical therapies. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews. 2005.
Leung RM, Smith TL, Rudmik L. Developing a laddered algorithm for the management of intractable epistaxis: a risk analysis. JAMA Otolaryngol–Head and Neck Surg. 2015;141(5):405-9. DOI: https://doi.org/10.1001/jamaoto.2015.106
Dedhia RC, Desai SS, Smith KJ, Lee S, Schaitkin BM, Snyderman CH, et al. Cost‐effectiveness of endoscopic sphenopalatine artery ligation versus nasal packing as first‐line treatment for posterior epistaxis. In International Forum of Allergy and Rhinology 2013;3(7):563-6. DOI: https://doi.org/10.1002/alr.21137
Wang L, Vogel DH. Posterior epistaxis: comparison of treatment. Otolaryngol Head and Neck Surg. 1981;89(6):1001-6. DOI: https://doi.org/10.1177/019459988108900624
Gandomi B, Arzaghi MH, Khademi B, Rafatbakhsh M. Endoscopic cauterization of the sphenopalatine artery to control severe and recurrent posterior epistaxis. Iranian J of Otorhinolaryngol. 2013;25(72):147.
Purkey MR, Seeskin Z, Chandra R. Seasonal variation and predictors of epistaxis. The laryngos. 2014;124(9):2028-33.
Purkey MR, Seeskin Z, Chandra R. Seasonal variation and predictors of epistaxis. The laryngos. 2014;124(9):2028-33. DOI: https://doi.org/10.1002/lary.24679
Barnes ML, Spielmann PM, White PS. Epistaxis: a contemporary evidence based approach. Otolaryngol Clinics of North America. 2012;45(5):1005-17. DOI: https://doi.org/10.1016/j.otc.2012.06.018
Snyderman CH, Goldman SA, Carrau RL, Ferguson BJ, Grandis JR. Endoscopic sphenopalatine artery ligation is an effective method of treatment for posterior epistaxis. American J Rhinol. 1999;13(2):137-40. DOI: https://doi.org/10.2500/105065899782106805
Klotz DA, Winkle MR, Richmon J, Hengerer AS. Surgical management of posterior epistaxis: a changing paradigm. The Laryng. 2002;112(9):1577-82. DOI: https://doi.org/10.1097/00005537-200209000-00008
Santos P. Epistaxis. In: Head and Neck Surgery-otolaryngology. Lippincott-Raven; 1998: 13–29.
Seno S, Arikata M, Sakurai H, Owaki S, Fukui J, Suzuki M, et al. Endoscopic ligation of the sphenopalatine artery and the maxillary artery for the treatment of intractable posterior epistaxis. Ame J Rhinol Aller. 2009;23(2):197-9. DOI: https://doi.org/10.2500/ajra.2009.23.3294
İsmi O, Vayisoğlu Y, Özcan C, Görür K, Ünal M. Endoscopic sphenopalatine artery ligation in posterior epistaxis: retrospective analysis of 30 patients. Turkish Arch Otorhinolaryngol. 2016;54(2):47. DOI: https://doi.org/10.5152/tao.2016.1713
Abdelkader M, Leong SC, White PS. Endoscopic control of the sphenopalatine artery for epistaxis: long-term results. The J of Laryngol and Otol. 2007;121(8):759-62. DOI: https://doi.org/10.1017/S0022215106003379
Holzmann D, Kaufmann T, Pedrini P, Valavanis A. Posterior epistaxis: endonasal exposure and occlusion of the branches of the sphenopalatine artery. Eur Arch Otorhinolaryngology. 2003;260:425-8. DOI: https://doi.org/10.1007/s00405-003-0618-7
Jones GL, Browning S, Phillipps J. The value of coagulation profiles in epistaxis management. Int J Clin Prac. 2003;57(7):577-8. DOI: https://doi.org/10.1111/j.1742-1241.2003.tb10561.x
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