Identification of bleeding sites and microwave thermal ablation of posterior epistaxis

Abstract

Background: Microwave ablation (MWA) is a relatively new technique which has been used to achieve hemostasis at surgical field. However, few publications have reported MWA for epistaxis.

Objectives: Our objectives were to identify the bleeding sites/points in instances of posterior epistaxis and to evaluate the efficacy of MWA for controlling bleeding.

Material and methods: Patients with posterior epistaxis who met the inclusion criteria were examined and treated endoscopically using MWA. Recurrent bleeding and complications were evaluated at 1 and 3 months after treatment.

Results: Of the 71 patients, the bleeding site/point was identified in 67 patients while 4 patients was unknown. Of the 67 patients with known bleeding sites, the olfactory cleft was in 44 patients, the middle meatus in 5 patients, and the inferior meatus in 18 patients. Only the bleeding point was coagulated in the 67 patients while prophylactic MWA in the 4 patients. No side effects or complications (including recurrent bleeding, crusting, nasal discomfort, and nasal septal perforation) were seen at 3-month follow-up.

Conclusions: MWA may effectively control posterior epistaxis with a low cost and without complications.

Chinese abstract

背景：微波消融术（MWA）是一种相对较新的技术, 已被用于外科止血。然而, 很少有报道关于用于鼻出血的MWA的文章。

目的：我们的目的是确定鼻后出血的部位/点, 并评价微波消融术（MWA）控制出血的疗效。

材料和方法：对符合入选标准的鼻后出血患者进行内镜检查, 并用内窥镜进行MWA治疗。治疗后1个月和3个月评估复发性出血和并发症。

结果：在71例患者中, 67例患者的出血部位/出血点被确定, 4例患者不明。在67例已知出血部位的患者中, 44例出现嗅裂, 5例出现中鼻道, 18例出现下鼻道。67例患者仅有出血点凝结, 4例患者接受预防性应用药MWA治疗。随访3个月未发现副作用或并发症（包括反复性出血、结痂、鼻不适和鼻中隔穿孔）。

结论：MWA可有效控制鼻后出血。该法成本低, 无并发症。

Keywords:

• Posterior epistaxis
• microwave thermal ablation
• prophylactic ablation
• recurrent bleeding

Disclosure statement

No potential conflict of interest was reported by the author(s).