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Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach

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Refractory epistaxis and Stamm's S-point.

Eduardo Macoto Kosugi¹, Leonardo Balsalobre^1,2, Aldo Cassol Stamm²

¹Rhinology Section, Otorhinolaryngoly and Head and Neck Surgery Department, Federal University of São Paulo (UNIFESP-EPM).

Current Opinion in Otolaryngology & Head and Neck Surgery

|December 27, 2021

Summary

This summary is machine-generated.

Stamm's S-point is a key source of severe refractory epistaxis. Endoscopic assessment is crucial for identifying this hidden bleeding point, with electrocauterization showing high success rates.

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Area of Science:

Otolaryngology
Rhinology
Vascular Surgery

Background:

Severe refractory epistaxis is increasingly linked to ethmoidal arteries.
Stamm's S-point, a posterior septal bleeding site, has been recently identified.

Purpose of the Study:

To review current data on Stamm's S-point.
To highlight its significance in managing severe refractory epistaxis.

Main Methods:

Review of recent literature on epistaxis and S-point.
Analysis of endoscopic findings in severe epistaxis cases.
Evaluation of treatment outcomes for S-point bleeding.

Main Results:

Stamm's S-point is frequently identified (23.7-28.3%) during endoscopic assessment for severe epistaxis.
Electrocauterization of the S-point demonstrates high success rates (91.5-100%).
Ethmoidal arteries are now considered a primary source, shifting focus from the sphenopalatine artery.

Conclusions:

Stamm's S-point is a significant factor in severe epistaxis.
Endoscopic evaluation is essential for identifying this often-hidden bleeding source.
Electrocauterization is an effective treatment for S-point related epistaxis, reducing recurrence.