Endoscopic management of superior and posterior refractory epistaxis by cauterization and ligation

Introduction; Epistaxis is one of the most common otorhinolaryngologic emergencies, often requires urgent and intensive care. The purpose of this study is to show the effectiveness of the endoscopic cauterization of the sphenopalatine artery and anterior ethmoidal artery in a severe posterior and superior epistaxis. Materials and Methods; From May 2006 to June 2011, sixteen consecutive patients with posterior and superior epistaxis were treated by (undergone) endoscopic cauterization and ligation of 11 shenoplatine arteries and cauterization of the 5 ethmoidal arteries. The age ranged from 22 to 75 years and they were 10 male and 6 female. Results: In all patients, their blood film was normal. All patients were discharged on 3rd postoperative day. In every case, no intra or post-operative complications were recorded in particular intracranial or intraorbital sequelae. Thirteen patients evolved without rebleeding after cauterization. In three cases epistaxis started again and they need sphenopalatine artery ligation. All patients have subsequently been followed up on average of 18 months with no further episodes of epistaxis. Conclusion; The endoscopic cauterization of the sphenopalatine artery and anterior ethmoidal artery in a severe posterior and superior epistaxis patient was proven to be safe and efficient.