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Related Concept Videos

Epistaxis01:30

Epistaxis

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Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
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Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
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Longstanding diplopia after ethmoidal artery ligation for epistaxis.

S Bischoff1, C Gerth-Kahlert2, D Holzmann1

  • 1Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|November 1, 2019
PubMed
Summary

Ethmoidal artery ligation effectively treats intractable epistaxis. However, a significant portion of patients experienced temporary diplopia, highlighting the need for informed consent regarding potential orbital motility complications.

Keywords:
DiplopiaEpistaxisEthmoidal arteryLigationOrbital complicationsSuperior oblique muscle

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Area of Science:

  • Otolaryngology
  • Ophthalmology

Background:

  • Intractable posterior epistaxis often necessitates surgical intervention.
  • Ligation of ethmoidal arteries via an external approach is a treatment option for severe cases.
  • Orbital complications, particularly extra-ocular motility disorders, are known but infrequently documented.

Purpose of the Study:

  • To analyze the types, rates, and outcomes of orbital complications following ethmoidal artery ligation for epistaxis.
  • To evaluate the effectiveness of ethmoidal artery ligation in managing intractable epistaxis.

Main Methods:

  • Retrospective analysis of patient data from 2012-2017.
  • Telephone interviews using a non-standardized questionnaire for follow-up.
  • Study design: Case Series, Level 4 evidence.

Main Results:

  • Eighteen patients (3 male, 15 female, aged 53-83) underwent ethmoidal artery ligation.
  • Epistaxis recurrence was low (1 patient).
  • Diplopia occurred in 5 patients (28%) post-surgery, with most recovering within 4-8 months.

Conclusions:

  • Anterior ethmoidal artery ligation is highly effective for intractable epistaxis.
  • Diplopia is a notable complication, affecting approximately one-third of patients.
  • Informed consent must detail potential motility restrictions, and surgical technique should carefully protect the trochlea and superior oblique muscle.