Eswaran Sudhagar, Ayyaswamy Anupriya, Saravanam Prasanna Kumar
Department of ENT, Head and Neck Surgery, Sri Ramchandra Institute of Higher Education and Research, Chennai, India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1348-1352. doi: 10.1007/s12070-021-02482-3. Epub 2021 Mar 11.
Endoscopic sinus surgery (ESS) is one of the common ENT surgeries performed. Various techniques are available for reducing the blood loss during ESS. The efficacy of cauterization of the SPA in reducing the per-operative blood loss has not been explored in the literature. This study evaluates the efficacy of SPA cauterization prior to sinus surgery and its per-operative and post-operative outcomes. To study the outcomes of endonasal SPA cauterization in patients undergoing ESS. This is a prospective observational study conducted in a tertiary care centre from October 2018 to October 2020. 30 patients underwent ESS where SPA was cauterized by bipolar diathermy in one side of the nasal cavity and in the contralateral side, SPA was not cauterized. The results were tabulated and compared between the cauterized and non cauterized side. value < 0.05 was considered as statistically significant. Mean blood loss ( value = 0.20), operating time ( value = 0.19), surgical field grade, post operative Lund Kennedy Score at 1st, 4th and 12th week were compared and the difference between cauterized and non cauterized was found to be statistically insignificant. In this study, endonasal SPA cauterization did not significantly reduce the intra operative bleeding and surgical field grade in patients undergoing ESS. SPA cauterization did not adversely affect the per operative and post operative outcome and hence authors highlight the fact that it can be safely performed in cases where severe intra operative bleeding is expected and its effectiveness can be studied better in such cases.
内镜鼻窦手术（ESS）是常见的耳鼻喉科手术之一。有多种技术可用于减少ESS期间的失血。文献中尚未探讨蝶腭动脉（SPA）烧灼术在减少术中失血方面的疗效。本研究评估鼻窦手术前SPA烧灼术的疗效及其术中及术后结果。研究接受ESS患者鼻内SPA烧灼术的结果。这是一项于2018年10月至2020年10月在三级医疗中心进行的前瞻性观察研究。30例接受ESS的患者中，一侧鼻腔通过双极电凝烧灼SPA，对侧未烧灼SPA。将结果制成表格，并对烧灼侧和未烧灼侧进行比较。P值<0.05被认为具有统计学意义。比较了平均失血量（P值=0.20）、手术时间（P值=0.19）、术野分级、术后第1周、第4周和第12周的Lund Kennedy评分，发现烧灼侧和未烧灼侧之间的差异无统计学意义。在本研究中，鼻内SPA烧灼术并未显著减少接受ESS患者的术中出血和术野分级。SPA烧灼术对术中及术后结果没有不利影响，因此作者强调，在预计术中会出现严重出血的情况下可以安全地进行该操作，并且在这类病例中可以更好地研究其有效性。
