Surgical and interventional radiological management of adult epistaxis: systematic review
| Autor: | Chloe Swords, Anant V. Patel, Richard Williams, Matthew E. Smith, Claire Hopkins, Isla Kuhn |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Cautery Nose Radiology Interventional 03 medical and health sciences 0302 clinical medicine medicine.artery medicine Humans 030223 otorhinolaryngology Adverse effect Ligation Stroke medicine.diagnostic_test business.industry Interventional radiology Arteries General Medicine medicine.disease Embolization Therapeutic Nasal packing Surgery Epistaxis Treatment Outcome medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Radiological weapon Sphenopalatine artery business |
| Zdroj: | The Journal of Laryngology & Otology. 131:1108-1130 |
| ISSN: | 1748-5460 0022-2151 |
| Popis: | Background:There is variation regarding the use of surgery and interventional radiological techniques in the management of epistaxis. This review evaluates the effectiveness of surgical artery ligation compared to direct treatments (nasal packing, cautery), and that of embolisation compared to direct treatments and surgery.Method:A systematic review of the literature was performed using a standardised published methodology and custom database search strategy.Results:Thirty-seven studies were identified relating to surgery, and 34 articles relating to interventional radiology. For patients with refractory epistaxis, endoscopic sphenopalatine artery ligation had the most favourable adverse effect profile and success rate compared to other forms of surgical artery ligation. Endoscopic sphenopalatine artery ligation and embolisation had similar success rates (73–100 per cent and 75–92 per cent, respectively), although embolisation was associated with more serious adverse effects (risk of stroke, 1.1–1.5 per cent). No articles directly compared the two techniques.Conclusion:Trials comparing endoscopic sphenopalatine artery ligation to embolisation are required to better evaluate the clinical and economic effects of intervention in epistaxis. |
| Databáze: | OpenAIRE |
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