Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-26T22:03:31.847Z Has data issue: false hasContentIssue false
  • English
  • Français

Peri-operative complications of sphenopalatine artery ligation: a 10-year series from two secondary care centres

Published online by Cambridge University Press:  27 January 2022

H M Yip ,
S Khosla ,
A Ashman ,
R Hettige ,
F Van Wyk  and
J Hern
H M Yip*
Affiliation:
Department of ENT, Wexham Park Hospital, Slough, UK
S Khosla
Affiliation:
Department of ENT, Frimley Park Hospital, Camberley, UK
A Ashman
Affiliation:
Department of ENT, Wexham Park Hospital, Slough, UK
R Hettige
Affiliation:
Department of ENT, Wexham Park Hospital, Slough, UK
F Van Wyk
Affiliation:
Department of ENT, Frimley Park Hospital, Camberley, UK
J Hern
Affiliation:
Department of ENT, Frimley Park Hospital, Camberley, UK
*
Author for correspondence: Dr Hao Meng Yip, Department of ENT, Wexham Park Hospital, Wexham Street, SloughSL2 4HL, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

There is currently limited evidence regarding the potential complications of sphenopalatine artery ligation. The post-operative outcomes at two secondary care centres over a 10-year period were reviewed.

Methods

A retrospective review was undertaken of patients undergoing emergency and elective sphenopalatine artery ligation between January 2011 and January 2021. Their demographics, peri-operative care and post-operative outcomes were recorded. The median follow-up time was 54 days (range, 0–2657 days).

Results

Ninety-one patients were included. Four patients (4.4 per cent) had a septal perforation at post-operative review. Nineteen patients (20.9 per cent) had post-operative bleeding that extended their in-patient stay, with five patients (5.5 per cent) requiring revision surgery. Pre-operative non-dissolvable nasal packing was used a median of 1 time (range, 0–8 times).

Conclusion

Further research on outcomes of sphenopalatine artery ligation is needed. Pre-operative non-dissolvable nasal packing, concurrent septal surgical procedures, surgical techniques, and co-morbidities such as hypertension represent potential confounding factors that could not be further assessed in this small, retrospective study.

Keywords

OtolaryngologyEpistaxisLigation
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 12 , December 2022 , pp. 1249 - 1253
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr H M Yip takes responsibility for the integrity of the content of the paper

References

National ENT Trainee Research Network. Epistaxis 2016: national audit of management. J Laryngol Otol 2017;131:1131–41CrossRefGoogle Scholar
Ellinas, A, Jervis, P, Kenyon, G, Flood, LM. Endoscopic sphenopalatine artery ligation for acute idiopathic epistaxis. Do anatomical variation and a limited evidence base raise questions regarding its place in management? J Laryngol Otol 2017;131:290–7CrossRefGoogle Scholar
Abdelkader, M, Leong, SC, White, PS. Endoscopic control of the sphenopalatine artery for epistaxis: long-term results. J Laryngol Otol 2007;121:759–62CrossRefGoogle ScholarPubMed
Malcomson, KG. The surgical management of massive epistaxis. J Laryngol Otol 1963;77:299–314CrossRefGoogle ScholarPubMed
Nouraei, SA, Maani, T, Hajioff, D, Saleh, HA, Mackay, IS. Outcome of endoscopic sphenopalatine artery occlusion for intractable epistaxis: a 10-year experience. Laryngoscope 2007;117:1452–6CrossRefGoogle ScholarPubMed
Kitamura, T, Takenaka, Y, Takeda, K, Oya, R, Ashida, N, Shimizu, K et al. Sphenopalatine artery surgery for refractory idiopathic epistaxis: systematic review and meta-analysis. Laryngoscope 2019;129:1731–6CrossRefGoogle ScholarPubMed
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. Int Forum Allergy Rhinol 2013;3:563–6CrossRefGoogle ScholarPubMed
McDermott, AM, O'Cathain, E, Carey, BW, O'Sullivan, P, Sheahan, P. Sphenopalatine artery ligation for epistaxis: factors influencing outcome and impact of timing of surgery. Otolaryngol Head Neck Surg 2016;154:547–52CrossRefGoogle ScholarPubMed
George, A, Smatanova, K, Joshi, H, Jervis, S, Oluwole, M. Sphenopalatine, anterior ethmoid and internal maxillary artery intervention in the management of refractory epistaxis: their efficacy in 25 patients. Clin Otolaryngol 2012;37:321–5CrossRefGoogle ScholarPubMed
Elsheikh, E, El-Anwar, MW. Septal perforation and bilateral partial middle turbinate necrosis after bilateral sphenopalatine artery ligation. J Laryngol Otol 2013;127:1025–7CrossRefGoogle ScholarPubMed
Walen, SG, Rudmik, LR, Lipkewitch, S, Dixon, E, Mechor, B. Training, practice, and referral patterns in rhinologic surgery: survey of otolaryngologists. J Otolaryngol Head Neck Surg 2010;39:297–303Google ScholarPubMed
Daudia, A, Jaiswal, V, Jones, NS. Guidelines for the management of idiopathic epistaxis in adults: how we do it. Clin Otolaryngol 2008;33:618–20CrossRefGoogle ScholarPubMed
Lakhani, R, Syed, I, Qureishi, A, Bleach, N. The Wexham Criteria: defining severe epistaxis to select patients requiring sphenopalatine artery ligation. Eur Arch Otorhinolaryngol 2013;270:2039–43CrossRefGoogle ScholarPubMed
Spielmann, PM, Barnes, ML, White, PS. Controversies in the specialist management of adult epistaxis: an evidence-based review. Clin Otolaryngol 2012;37:382–9CrossRefGoogle ScholarPubMed
Howe, DJ, Wazir, U, Skinner, DW. Outcomes of endoscopic sphenopalatine artery ligation for epistaxis: a five-year series from a single institution. Ear Nose Throat J 2012;91:70–2CrossRefGoogle ScholarPubMed
Tessler, I, Warman, M, Sharav, S, Rotem Batito, H, Halperin, D, Cohen, O. The role of endoscopic sphenopalatine artery ligation in the management of persistent epistaxis - a 15-year single-center experience. Am J Otolaryngol 2020;41:102715CrossRefGoogle ScholarPubMed
Basnet, M, Ghimire, B, Shrestha, A, Aryal, GR. Success rate of endoscopic sphenopalatine artery ligation for the management of refractory posterior epistaxis patients in a tertiary care hospital: a descriptive cross-sectional study. JNMA J Nepal Med Assoc 2020;58:1056–60Google Scholar
Cetiner, H, Cavusoglu, I, Duzer, S. The effect of smoking on perforation development and healing after septoplasty. Am J Rhinol Allergy 2017;31:63–5CrossRefGoogle ScholarPubMed
Elwany, S, Kamel, T, Mekhamer, A. Pneumatic nasal catheters: advantages and drawbacks. J Laryngol Otol 1986;100:641–7CrossRefGoogle ScholarPubMed
Moorthy, R, Anand, R, Prior, M, Scott, PM. Inferior turbinate necrosis following endoscopic sphenopalatine artery ligation. Otolaryngol Head Neck Surg 2003;129:159–60CrossRefGoogle ScholarPubMed