An evaluation and clinical study of severe epistaxis treated by arterial ligation

Forty-three cases of intractable epistaxis treated by major arterial ligation are described, with follow-up in 41 cases of up to 11 years. It would appear that this treatment is effective in the control of epistaxis, and there was no evidence of any long-term detrimental effect on the nose, or of any significant mortality. External carotid artery ligation is advocated in the elderly and debilitated case, whilst internal maxillary artery ligation together with anterior ethmoidal artery ligation is indicated in the younger age group, or in the elective case. Evaluation of the results is discussed together with alternative methods of management.