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[筛前动脉的内镜结扎术:一项尸体解剖研究]

[Endoscopic ligation of the anterior ethmoidal artery: a cadaver dissection study].

作者信息

Araujo Filho Bernardo Cunha, Pinheiro-Neto Carlos Diógenes, Ramos Henrique Faria, Voegels Richard Louis, Sennes Luiz Ubirajara

机构信息

Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP.

出版信息

Braz J Otorhinolaryngol. 2011 Jan-Feb;77(1):33-8. doi: 10.1590/s1808-86942011000100006.

Abstract

Anterior ethmoidal artery (AEA) ligation may be necessary in cases of severe epistaxis not controllable with traditional therapy. Endoscopic endonasal ligation of the AEA is not used frequently; there are few studies in the literature for standardization of the endoscopic technique for this vessel. To demonstrate the feasibility of periorbital AEA ligation in a transethmoidal endoscopic approach. A prospective study where 50 nasal cavities were dissected. After anterior ethmoidectomy and partial removal of lamina papyracea, the periorbital area was carefully dissected along a subperiosteal plane to identify the AEA. The vessel was exposed within the orbit and dissected. Data on technical difficulties, complications, the learning curve and anatomical variations were gathered. An endonasal endoscopic approach to the AEA within the orbit was shown to be feasible. Identifying the artery is not difficult, and this technique avoids external incisions. This approach appears to be an excellent alternative for approaching the AEA. Further clinical studies are needed to demonstarte the benefits of this technique.

摘要

对于传统治疗无法控制的严重鼻出血病例,可能需要结扎筛前动脉(AEA)。鼻内镜下经鼻结扎AEA并不常用;文献中关于该血管内镜技术标准化的研究很少。为了证明经筛窦鼻内镜入路眶周结扎AEA的可行性。进行了一项前瞻性研究,对50个鼻腔进行解剖。在前筛窦切除和部分纸样板切除后,沿骨膜下平面仔细解剖眶周区域以识别AEA。该血管在眼眶内暴露并进行解剖。收集了有关技术难度、并发症、学习曲线和解剖变异的数据。结果表明,经鼻内镜入路处理眼眶内的AEA是可行的。识别动脉并不困难,且该技术避免了外部切口。这种入路似乎是处理AEA的一种极佳替代方法。需要进一步的临床研究来证明该技术的优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f75a/9442171/788cc0207d36/gr1.jpg

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