Karligkiotis Apostolos, Volpi Luca, Abbate Vincenzo, Battaglia Paolo, Meloni Francesco, Turri-Zanoni Mario, Bignami Maurizio, Castelnuovo Paolo
Division of Otorhinolaryngology, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Azienda Ospedaliero Universitaria, Viale San Pietro 43, 07100, Sassari, Italy,
Eur Arch Otorhinolaryngol. 2014 Oct;271(10):2839-43. doi: 10.1007/s00405-014-3111-6. Epub 2014 Jun 6.
The palatovaginal or pharyngeal artery is a small branch of the internal maxillary artery supplying the nasopharynx. Bleeding from this artery is exceptional and only one case of traumatic epistaxis from this artery has been reported previously. We report a case of a 66-year-old male presenting with right recurrent posterior epistaxis. Endoscopic dissection of the pterygopalatine fossa and direct visualization of the palatosphenoidal canal permitted to identify the origin of bleeding, and coagulation of the pharyngeal artery solved the epistaxis. Although rare, intractable posterior epistaxis may arise from the pharyngeal artery. The anatomical knowledge of this artery and of the palatosphenoidal canal is of outmost importance in endoscopic transpterygoid and nasopharyngeal procedures, to identify the vidian canal, evaluate nasopharyngeal cancer spread in the pterygopalatine fossa, reduce bleeding during surgery of the nasopharynx, and harvest adequately the pedicle of the nasoseptal flap.
腭鞘管动脉或咽动脉是上颌内动脉的一个小分支，供应鼻咽部。该动脉出血极为罕见，此前仅报道过1例该动脉外伤性鼻出血的病例。我们报告1例66岁男性复发性右后鼻出血病例。经翼腭窝内镜下解剖并直接观察腭蝶管，得以确定出血来源，对咽动脉进行凝血处理后鼻出血得以解决。尽管罕见，但难治性后鼻出血可能源于咽动脉。在翼内肌内镜和鼻咽部手术中，了解该动脉及腭蝶管的解剖结构对于识别翼管、评估鼻咽癌在翼腭窝的扩散、减少鼻咽部手术出血以及充分获取鼻中隔瓣蒂至关重要。
