Specific vessel ligation for epistaxis: survey of 60 cases.

Abstract

AbstractIn a survey of 60 cases of internal maxillary artery ligation, only six therapeutic failures were encountered. Causes of failure were incorrect selection of vessel (four cases), and inadequate ligation of the artery (two cases). Initial identification of the bleeding site may be hampered by profuse bleeding or by anatomical obstruction, but correct localization will result in higher success rate for the procedure. Certain areas of the nose may receive blood from more than one artery. In these instances, ligation of both the internal maxillary and anterior ethmoid artery may be necessary.No relationship can be found in the series between hypertension and massive epistaxis. Neither did epistaxis predispose the hypertensive patient to imminent death.Hospitalization for treatment of massive epistaxis is shortened by specific vessel ligation as compared to posterior packing. Complications from the procedure cōnsists of cheek numbness in three cases and epiphora in one case. Care must be taken when isolating the vessels to avoid massive bleeding.Vessel ligation is an acceptable and effective means of controlling massive epistaxis.