Indications and results of cauterization by endoscopic approach of the sphenopalatine artery in severe posterior epistaxis

Objectives: The authors present a retrospective study concerning cauterization by endoscopic approach of the sphenopalatine artery in the treatment of severe posterior epistaxis. The purpose is to evaluate the effectiveness of these therapeutics, their complications, to determine their indications and their contributions to the therapeutic arsenal of the treatment of severe epistaxis. Patients and method: This study concerns 10 patients, which have been operated in the department of ORL head and neck surgery of Strasbourg and treated over a 23-month period (from January 2001 to November 2002), for clinically labelled posterior origin epistaxis. A preliminary treatment, by anterior and posterior tamponage, using a Brighton Epistaxis Balloon was carried out (n=8); the use of an associated ligature of the ethmoidal arteries was sometimes necessary during operative time (n=4). Results: Hemorrhagic control with absence of recurrence was the rule (n=9). A complementary interventional radiology embolization due to failure was necessary in one case. The average duration of post-surgical hospitalization was of 2.1 days. No post-surgical complications were noted. Conclusion: Cauterization by endonasal approach of the sphenopalatine artery in severe posterior epistaxis is a reliable intervention. Its role is clearly defined in our department, after failure of traditional treatments by packing methods.