Metson R, Lane R
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.
Laryngoscope. 1988 Jul;98(7):760-4. doi: 10.1288/00005537-198807000-00015.
The records of 100 consecutive patients undergoing transantral ligation of the internal maxillary artery (IMA) for epistaxis, including 15 patients who developed postoperative bleeding, were reviewed. Preoperative parameters predictive of surgical failure were advanced age, anemia, and a history of hypertension. The causes of postoperative epistaxis, as determined by surgical reexploration or angiography in 12 cases, included failure to identify the IMA in the pterygomaxillary space (6 cases), blood flow through partially closed clips on the IMA (2 cases), bleeding from posterior ethmoid arteries (2 cases), and revascularization of the nasal blood supply (2 cases). The incidence of surgical failure may be reduced by proper techniques of IMA identification and ligation.
回顾了100例因鼻出血接受经上颌窦结扎上颌内动脉（IMA）的连续患者的记录，其中15例出现术后出血。预测手术失败的术前参数为高龄、贫血和高血压病史。通过12例手术再次探查或血管造影确定的术后鼻出血原因包括在翼腭窝未识别出IMA（6例）、IMA上部分闭合夹有血流通过（2例）、筛后动脉出血（2例）以及鼻供血血管再通（2例）。通过正确的IMA识别和结扎技术，手术失败的发生率可能会降低。
