Anterior Ethmoid Artery Ligation for Epistaxis: A Systematic Review

Area of Science:

• Otolaryngology
• Neurosurgery
• Ophthalmology

Background:

• Intractable epistaxis often requires surgical intervention.
• Anterior ethmoid artery ligation (AEAL) is a key surgical option for superior nasal cavity bleeding.
• Limited literature exists on AEAL outcomes and complications.

Purpose of the Study:

• To systematically review the outcomes of anterior ethmoid artery ligation (AEAL) for epistaxis control.
• To identify and analyze complications associated with various AEAL approaches.

Main Methods:

• Systematic review of MEDLINE and PubMed for English-language studies.
• Inclusion of full-text studies on AEAL in human subjects.
• Data extraction and descriptive statistics following PRISMA guidelines.

Main Results:

• 122 patients underwent AEAL via external Lynch incision (76.2%), transnasal endoscopic (9.8%), or transcaruncular (13.9%) approaches.
• Postoperative bleeding occurred in 7/108 patients; 28.3% experienced complications.
• Lynch incision complications included orbital edema, ptosis, diplopia, and ophthalmoplegia.

Conclusions:

• AEAL is effective for epistaxis in select patients.
• Complications, particularly from the Lynch incision, are often temporary.
• Further research is needed to refine AEAL approaches for intractable epistaxis.