El-Guindy A
Department of Otolaryngology, Tanta School of Medicine, Egypt.
Ann Otol Rhinol Laryngol. 1998 Dec;107(12):1033-7. doi: 10.1177/000348949810701207.
The rigid nasal endoscope was used through a transseptal approach to reach the sphenopalatine foramen and to ligate its artery in 9 patients with intractable posterior epistaxis. Immediate and complete cessation of the bleeding uniformly occurred, except in 1 case, in which there was persistent bleeding on endoscopic examination of the nasal cavity at the end of the procedure. The ligature was checked and the artery was reclipped. Thereafter, the patient's recovery was uncomplicated and free of further epistaxis. Endoscopic transseptal sphenopalatine artery ligation offers a reliable option in the treatment of intractable posterior epistaxis. The submucoperiosteal dissection reduces bleeding, shortens operation time, and allows relatively easy identification of the sphenopalatine foramen. The procedure allows direct positive control of the major vessel supplying the posterior nasal cavity. It avoids the complications associated with transantral and pterygopalatine fossa surgery.
采用经鼻中隔入路，使用硬性鼻内镜，对9例难治性鼻后段出血患者到达蝶腭孔并结扎其动脉。除1例患者外，其余患者均立即完全止血，该例患者在手术结束时鼻腔内镜检查仍有持续出血。检查结扎线并重新夹闭动脉。此后，患者恢复顺利，未再发生鼻出血。内镜下经鼻中隔蝶腭动脉结扎术为难治性鼻后段出血的治疗提供了一种可靠的选择。黏膜下骨膜下剥离可减少出血、缩短手术时间，并使蝶腭孔的识别相对容易。该手术可直接有效控制供应鼻腔后部的主要血管。它避免了经鼻窦和翼腭窝手术相关的并发症。
