Abstract

Objective: Determine the effectiveness of Anterior Ethmoidal Artery endoscopic transorbital cauterization for recurrent posterior epistaxis treatment.

Study Design: Descriptive prospective.

Materials and methods: All the patients treated for recurrent posterior epistaxis by endoscopic transorbital cauterization in the Rhinosinusology division of the Otolaryngology department of the Italian Hospital of Buenos Aires between June 2007 and May 2017 were included.

Results: Forty-Five patients underwent an endoscopic surgical procedure for posterior epistaxis between June 2007 and May 2017. 23 of them were men and 22 women, the average age was 65 years. In 33 cases, only the SA was cauterized. In 12 cases, both the SA and the AEA as it traveled through the skull base. Three of the 12 patients in whom SA+AEA was cauterized had recurrent epistaxis. In two of them the AEA was cauterized with endoscopic transorbital technique. Both were women of 64 and 66 years old. The time of hospitalization after the surgery was 48 hours and there were no complications. They were controlled without referring any new bleeding.

Conclusion: The effectiveness of cauterization of the anterior ethmoidal artery performed by endoscopic transorbital approach due to recurrent posterior epistaxis was 100%. We consider that due to the anatomical variability of the artery and the greater possibility of complications with other surgical techniques, the endoscopic transorbital approach is the best option to resolve the posterior epistaxis when the origin is the anterior ethmoidal artery. Due to the few studies published and small series of patients, the role of this surgical technique depends on the results of a greater number of patients treated through this approach.

Keywords: Anterior; Ethmoidal; Artery; Endoscopic; Surgery

Abbreviations: AEA: Anterior Etmoidal Artery; SA: Sphenopalatine Artery; AEC: Anterior Ethmoidal Canal