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An Analysis of 31 Cases

Topi M. J. Siniluoto, MD; Aaro S. S. Leinonen, MD; Ari I. Karttunen, MD; Heino K. Karjalainen, MD; Kalevi E. Jokinen, MD

Arch Otolaryngol Head Neck Surg. 1993;119(8):837-841.

Abstract
• Thirty-one patients with posterior epistaxis refractory to nasal packing alone or in combination with surgical ligation (n=8) underwent diagnostic angiography and therapeutic embolization of the internal maxillary artery. Embolization resulted in the cure of epistaxis in 22 cases (71.0%). Of the nine failures (29.0%), seven underwent successful surgical clipping of the ethmoid arteries, and two were treated conservatively and died of their primary hematologic disease within 33 days. Late rebleeding occurred in two patients: one underwent reembolization and the other was treated surgically. No severe or permanent complications occurred. The results indicate that embolization is a feasible alternative to surgical intervention for patients with posterior epistaxis, and we recommend it as the treatment of choice in cases with high surgical risk or failure of prior arterial ligation.

(Arch Otolaryngol Head Neck Surg. 1993;119:837-841)

Author Affiliations
From the Departments of Diagnostic Radiology (Drs Siniluoto, Leinonen, and Karttunen) and Otorhinolaryngology (Drs Karjalainen and Jokinen), University Central Hospital of Oulu, University of Oulu (Finland).

Footnotes
Accepted for publication January 22, 1993.

Reprint requests to Department of Diagnostic Radiology, University of Oulu, Kajaanintie 50, SF-90220 Oulu, Finland (Dr Siniluoto).

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