Microwave ablation for the treatment of arterial epistaxis: "how I do it".

Abstract

Arterial epistaxis is commonly seen in the rhinology clinic and can have a significant impact on quality of life. Previous studies have explored various therapies to address epistaxis. Patients were treated in the outpatient clinic or operating room by microwave ablation (MWA) with a 2450-MHz cooled-shaft antenna to treat an epistaxis bleeding point. Of the 481 patients with arterial epistaxis, bleeding was controlled within 1 to 2 minutes and only 2 patients with recurrent bleeding required re-ablation. The shape of the thermal lesion was elliptical and it was approximately 2 mm in length, 1 mm in width, and 0.5 to 1 mm in penetration depth. Of the 481 patients, 167 (34.7%) complained of minor nasal pain on the same day of ablation. No patients complained of nasal pain or obstruction during the follow-up period. In addition, 139 (28.9%) patients showed a minor increase in rhinorrhea during the first postoperative week. Of the 481 patients, 469 (97.5%) were followed-up at 6 months with no severe MWA-related complications, such as septal perforation, synechiae formation, or orbit and brain complications. MWA is a technically feasible alternative method for patients with arterial epistaxis.