An Dong-Jiao, Li Zu-Fei, Zhao Xiao-Chang, Liu Jin-Feng
Department of Anaesthesiology, Beijing Chaoyang Hospital Capital Medical University Beijing China.
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital Capital Medical University Beijing China.
World J Otorhinolaryngol Head Neck Surg. 2023 Jul 4;10(3):241-243. doi: 10.1002/wjo2.113. eCollection 2024 Sep.
To report a rare variant of the posterior septal artery (PSA), which supplies blood to the posterior mucosa of the contralateral nasal septum.
A 31-year-old female patient underwent suture removal 14 days after septoplasty and developed left-sided epistaxis 6 h after suture removal. To safely and effectively relieve the patient from epistaxis, the cauterization of the left PSA was performed under general anesthesia. However, 24 h after the first surgical hemostasis, the patient experienced epistaxis again in the right nasal cavity. We have reviewed the patient's sinus computed tomography again and found a rare variant of PSA, which is the right-sided PSA passing through a bony canal in the left-sided nasal septum.
The variant of PSA well explained the failure of the first hemostatic surgery. Therefore, we again performed a cauterization of the right-sided PSA, after which the patient recovered and no further epistaxis occurred.
When cauterization of PSA is used to manage posterior epistaxis, it is necessary to pay attention to the possible variation in PSA.
报告一种罕见的鼻中隔后动脉（PSA）变异情况，该动脉为对侧鼻中隔后部黏膜供血。
一名31岁女性患者在鼻中隔成形术后14天拆线，拆线后6小时出现左侧鼻出血。为安全有效地缓解患者鼻出血症状，在全身麻醉下对左侧PSA进行了烧灼止血。然而，首次手术止血24小时后，患者右侧鼻腔再次出血。我们再次复查了患者的鼻窦计算机断层扫描，发现了一种罕见的PSA变异情况，即右侧PSA穿过左侧鼻中隔的骨管。
PSA的变异很好地解释了首次止血手术失败的原因。因此，我们再次对右侧PSA进行了烧灼止血，此后患者康复，未再发生鼻出血。
当使用烧灼PSA来处理后部鼻出血时，有必要注意PSA可能存在的变异情况。
