Identification of bleeding sites and microwave thermal ablation of posterior epistaxis

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.

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

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.

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.

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