İsmi Onur, Vayisoğlu Yusuf, Özcan Cengiz, Görür Kemal, Ünal Murat
Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.
Turk Arch Otorhinolaryngol. 2016 Jun;54(2):47-52. doi: 10.5152/tao.2016.1713. Epub 2016 Jun 1.
Although posterior epistaxis is rarely seen, it is an important medical problem that both decreases the quality of life of the patient and causes difficulties in the management for otorhinolaryngologists. In this study, we aimed to present the results of 30 patients who underwent transnasal endoscopic sphenopalatine artery ligation (TESPAL) for posterior epistaxis in our department.
The records of 30 patients who underwent TESPAL from January 2014 to April 2016 were analyzed retrospectively, and the relationship between perioperative factors and need for revision surgery was assessed.
The success rate of TESPAL in posterior epistaxis was 90%. There was no relationship between surgical failure and antiaggregant use (p=0.224), anticoagulant use (p=0.534), hypertension (p=0.564), previous nasal surgery (p=0.279), and bilateral TESPAL application (p=0.279). TESPAL was seen to be effective in cases with Osler-Weber-Rendu disease, pregnancy, and uncontrollable epistaxis after rhinoplasty surgery. Mortality was seen in one of our patients not related to endoscopic ligation in the follow-up period.
TESPAL is an effective method in the treatment of posterior epistaxis. Hypertension, antiaggregant or anticoagulant use, bilateral sphenopalatine artery ligation, and previous nasal surgery do not seem to be factors leading to surgical failure.
尽管后鼻孔出血很少见，但它是一个重要的医学问题，既会降低患者的生活质量，又会给耳鼻喉科医生的治疗带来困难。在本研究中，我们旨在呈现30例在我科接受经鼻内镜蝶腭动脉结扎术（TESPAL）治疗后鼻孔出血患者的结果。
回顾性分析2014年1月至2016年4月期间接受TESPAL治疗的30例患者的记录，并评估围手术期因素与再次手术需求之间的关系。
TESPAL治疗后鼻孔出血的成功率为90%。手术失败与使用抗血小板药物（p = 0.224）、抗凝药物（p = 0.534）、高血压（p = 0.564）、既往鼻部手术（p = 0.279）及双侧TESPAL应用（p = 0.279）之间均无关联。TESPAL在治疗遗传性出血性毛细血管扩张症、妊娠及隆鼻手术后无法控制的鼻出血病例中被证明是有效的。在随访期间，我们有1例患者死亡，与内镜结扎无关。
TESPAL是治疗后鼻孔出血的有效方法。高血压、使用抗血小板或抗凝药物、双侧蝶腭动脉结扎及既往鼻部手术似乎并非导致手术失败的因素。
