Objective: To investigate the methodology and efficacy of endoscopic sphenopalatine artery diathermy in management of refractory epistaxis.
Method: Twenty patients with severe intractable posterior epistaxis, who had underwent various procedures like nasal packing, electro- or chemical cautery or others and still exacerbated, were subjected to this study. Under general anesthesia, according to the endoscopic anatomy of the sphenopalatine foramen, the sphenopalatine artery was identified under the posterior tip of the middle turbinate. After the pedicle of the artery was delineated, a bipolar cauterized the artery and transected it.
Result: Twenty patients have been followed up for 5 to 20 months with an average of 10 months. No patients suffered recurrent epistaxis during the period. Only 1 patients in this series reported minor nasal adhesion.
Conclusion: Diathermy of sphenopalatine artery, as a purely endonasal procedure, is an effective and microinvasive means of achieving long-term control of refractory epistaxis. It has few complications associated with other forms of arterial ligation.