Microwave ablation: A new technique for the prophylactic management of idiopathic recurrent epistaxis

The objective of this study was to compare the re-bleeding of idiopathic recurrent epistaxis with no definite bleeding site treated with either prophylactic microwave ablation (MWA) or continuous observation.

Case series with chart review.

61 patients with idiopathic recurrent epistaxis but no definite bleeding sites in the first operation were assigned to prophylactic MWA group (n = 39) and continuous observation group (n = 22). Patients in prophylactic MWA group were given prophylactic MWA at the common bleeding sites. Patients in continuous observation group were only observed in the ward. The bleeding sites, re-bleeding and complications were evaluated during 3 months follow-up period.

Rebleeding was experienced by 7 of the patients (17.9%) who were treated with prophylactic MWA whereas, 13 of the patients (59.1%) who used continuous observation had rebleeding. The rebleeding rate for patients undergoing prophylactic MWA group was lower than that for the observation-only group (p < 0.01). All the ablations were completed for the patients with known bleeding site within 1-2 min. These patients only had the complain of slight postoperative pain, no serious complications (including nasal adhesion, crust, septal perforation, etc.) were found in the follow-up period.

MWA is a simple, convenient, rapid, and definite hemorrhage control method with minimally invasive therapeutic technique. Prophylactic MWA at the common bleeding sites helps to significantly reduce the rate of rebleeding in patients in whom no definite bleeding sites have been identified.