[Principles of interventional treatment in epistaxis]

Area of Science:

• Otolaryngology
• Interventional Radiology

Background:

• Epistaxis is a common ENT emergency, rarely leading to hospital admission.
• Recurrent posterior epistaxis is a primary indication for inpatient care.
• Conventional treatments like packing and surgery may be insufficient for severe cases.

Purpose of the Study:

• To highlight endovascular therapy as a crucial treatment for refractory posterior epistaxis.
• To emphasize the diagnostic and therapeutic role of imaging in managing epistaxis.
• To assess the efficacy and safety of endovascular interventions.

Main Methods:

• Review of cases involving posterior epistaxis requiring advanced intervention.
• Utilization of CT (computed tomography) of paranasal sinuses and CT-angiography for diagnosis.
• Performance of endovascular embolization procedures.

Main Results:

• Endovascular therapy is a viable, sometimes the only, treatment for persistent or recurrent posterior epistaxis.
• Pre-embolization imaging accurately identifies hemorrhage sources, anatomical variations, and potential causes.
• Endovascular treatment demonstrates high success rates with low periprocedural risks.

Conclusions:

• Endovascular therapy is effective for posterior epistaxis unresponsive to conventional otolaryngologic management.
• Comprehensive imaging is essential for guiding endovascular treatment and understanding epistaxis etiology.
• Understanding vascular anatomy is key to successful and safe endovascular embolization for epistaxis.