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Endoscopic cauterization of the sphenopalatine artery in pediatric intractable posterior epistaxis
Hesham Mohammad Eladl1, Yasser W Khafagy, Mahamad Abu-Samra
1ORL Department Mansoura University, Mansoura, Egypt. heshameladl@mans.edu.eg
Insights
Endoscopic sphenopalatine artery cauterization is a safe and effective treatment for intractable posterior epistaxis in children. This minimally invasive technique showed no recurrence or complications in a pediatric study.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Endoscopic Sinonasal Surgery
Background:
- Intractable posterior epistaxis poses a significant challenge in pediatric patients.
- Traditional treatments may have limitations in efficacy and safety for children.
Purpose of the Study:
- To assess the technical difficulty, efficacy, and safety of endoscopic sphenopalatine artery cauterization for posterior epistaxis in children.
- To evaluate this endoscopic approach in the pediatric age group.
Main Methods:
- A retrospective study was conducted on 7 pediatric patients (age 8-14) with idiopathic intractable posterior epistaxis.
- All patients underwent preoperative evaluations and endoscopic sphenopalatine artery cauterization.
Main Results:
- No epistaxis recurrence was observed during the average 17.8-month follow-up period.
- No postoperative complications were reported, indicating a safe procedure.
Conclusions:
- Endoscopic sphenopalatine artery cauterization is an effective and safe method for pediatric posterior epistaxis.
- Surgeons require expertise in pediatric endoscopic sinonasal anatomy for optimal outcomes.
- Minimizing cauterization and avoiding excessive lateral wall application are crucial to prevent complications.
Objective:
To evaluate the rule of endoscopic sphenopalatine artery cauterization in posterior intractable epistaxis in pediatric age group as regard technical difficulty, efficacy, and safety in children.
Study Design:
Retrospective study.
Patients And Methods:
From March 2008 to February 2011, 7 children (4 male, 3 female) with idiopathic intractable posterior epistaxis, patients' age ranged from 8 to 14 years (10.7 average). All patients underwent preoperative laboratory investigations to exclude bleeding or coagulation disorders and CT paranasal sinus. All patients underwent endoscopic sphenopalatine artery cauterization (7 procedures for 7 patients, 5 were in the right side and 2 were in the left side).
Results:
postoperative evaluation showed no recurrence for epistaxis during the post operative follow up period. Also, no complications were found. The average follow up period was 17.8 months.
Conclusions:
Endoscopic cauterization of sphenopalatine artery in pediatric age group was effective and safe technique providing that the surgeon has a good experience regarding pediatric endoscopic sinonasal anatomy. Minimal endoscopic technique in this age group is important to avoid unnecessary operative and postoperative complications. Avoid excessive cauterization to lateral nasal wall in this technique is crucial to avoid unexpected nerve injury or tissue necrosis.
