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Percutaneous embolization to control intractable epistaxis in nasopharyngeal carcinoma
J S Mok1, J N Marshall, M Chan
1Department of Surgery, Division of Otorhinolaryngology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T.
Background:
Epistaxis in patients with nasopharyngeal carcinoma (NPC) who have received radiotherapy can be difficult to control by conventional methods. The use of angiography and embolization to control problematic epistaxis has been well documented in other situations, but its use in severe or recurrent epistaxis following irradiation for NPC has not been described.
Methods:
We retrospectively reviewed case notes of all patients with NPC initially seen with epistaxis over a 4-year period. Those patients with refractory epistaxis which could not be controlled by conventional methods and required angiography and embolization were assessed.
Results:
Eight patients who underwent angiography were identified. Five patients showed hypervascularization and three patients had pseudoaneurysms or an aneurysm of the internal carotid artery seen on the angiogram. All these patients were successfully embolized. There were no significant complications after the procedure.
Conclusion:
We conclude that embolization is a safe and effective method of controlling refractory epistaxis in patients irradiated for NPC.