Transantral sphenopalatine artery ligation

Area of Science:

• Otolaryngology
• Vascular Surgery
• Anatomy

Background:

• Posterior epistaxis is a common and potentially severe condition.
• Traditional treatments may involve packing or more invasive surgical interventions.
• Sphenopalatine artery branches are a frequent source of posterior nosebleeds.

Purpose of the Study:

• To introduce and evaluate a new surgical technique for ligating the sphenopalatine artery or its branches.
• To demonstrate the efficacy and safety of a transantral approach for controlling posterior epistaxis.
• To provide an alternative to pterygomaxillary fossa interventions.

Main Methods:

• A transantral approach is utilized, accessing the posterior medial antral wall.
• The mucoperiosteum of the lateral nasal wall is elevated to expose the sphenopalatine vessels.
• Direct ligation of the sphenopalatine artery or its branches is performed as they exit the sphenopalatine foramen.

Main Results:

• The technique allows for direct and specific ligation of the terminal vessels.
• Operations are characterized by ease and speed.
• Successful control of severe posterior epistaxis was achieved in 14 consecutive cases.
• Complications associated with the pterygomaxillary space were avoided.

Conclusions:

• Direct ligation of sphenopalatine artery branches via a transantral approach is a rapid and effective method for managing posterior epistaxis.
• This technique offers significant advantages, including specificity, speed, and avoidance of pterygomaxillary space-related complications.
• The described method represents a valuable advancement in the surgical treatment of severe nosebleeds.