Management of intractable spontaneous epistaxis

Luke Rudmik, Timothy L. Smith

Research output: Contribution to journalReview article

46 Scopus citations

Abstract

Background: Epistaxis is a common otolaryngology emergency and is often controlled with first-line interventions such as cautery, hemostatic agents, or anterior nasal packing. A subset of patients will continue to bleed and require more aggressive therapy. Methods: Intractable spontaneous epistaxis was traditionally managed with posterior nasal packing and prolonged hospital admission. In an effort to reduce patient morbidity and shorten hospital stay, surgical and endovascular techniques have gained popularity. A literature review was conducted. Results: Transnasal endoscopic sphenopalatine artery ligation and arterial embolization provide excellent control rates but the decision to choose one over the other can be challenging. The role of transnasal endoscopic anterior ethmoid artery ligation is unclear but may be considered in certain cases when bleeding localizes to the ethmoid region. Conclusion: This article will focus on the management of intractable spontaneous epistaxis and discuss the role of endoscopic arterial ligation and embolization as it pertains to this challenging clinical scenario.

Original languageEnglish (US)
Pages (from-to)55-60
Number of pages6
JournalAmerican Journal of Rhinology and Allergy
Volume26
Issue number1
DOIs
StatePublished - Jan 2012

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

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