National long-lasting effect of endonasal endoscopic sphenopalatine artery clipping for epistaxis

Abstract

Conclusion: We consider sphenopalatine artery ligation to be a safe and effective treatment of posterior epistaxis as the long-term need for revision surgery and the complication rates are low. Surgery should be considered earlier in the treatment of posterior epistaxis. Objectives: Posterior epistaxis is common and surgical endoscopic ligation of the sphenopalatine arteries is indicated in severe cases. Knowledge about long-term effects and complications is sparse. Methods: Within 2001–2006, 78 patients underwent endonasal endoscopic-guided surgery for posterior epistaxis in one of the eight ENT clinics in Denmark treating these patients. In 2011, 45 patients were still alive and eligible for the study. Patients were contacted by telephone and invited to complete an interview questionnaire on late adverse affects and recurrence. Results: In all, 42 of 45 patients participated in the mean follow-up. The mean follow-up was 6.7 years: 90% of patients (n = 38) obtained an effect of the treatment during follow-up; 78% (n = 33) had no recurrent epistaxis, 12% (n = 5) had recurrent epistaxis but only needed non-surgical specialized treatment; 10% (n = 4) required revision surgery due to recurrent epistaxis within the 6.7 mean years of follow-up; and 26% of the patients had minor postoperative complications, permanent nasal crusting being most persistent and frequent.

Keywords::

• Ligation
• endoscopic
• follow-up
• adverse effects

Acknowledgements

We would like to thank the following departments for contributing to this article: Ear, Nose and Throat Departments of Copenhagen, Gentofte, Hillerød, Holstebro, Slagelse, Svendborg, Sønderborg, Viborg, and Århus.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.