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Resection of the ethmoidal crest in sphenopalatine artery surgery
Author(s) -
Saraceni Neto Paulo,
Nunes Leonardo Mendes Acatauassu,
Caparroz Fabio de Azevedo,
Gregorio Luciano Lobato,
Souza Rafael de Paula e Silva Felice,
Simões Juliana Caminha,
Kosugi Eduardo Macoto
Publication year - 2017
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21832
Subject(s) - medicine , surgery , otorhinolaryngology , randomized controlled trial
Background In severe cases of epistaxis, in spite of several procedures described in the literature for its management, surgical treatment has been recognized by most authors as 1 of the most effective, especially when it includes ligation and/or electrocoagulation of the nasal branches of the sphenopalatine artery. The objective of this study is to determine the importance of ethmoid crest resection during sphenopalatine artery surgery, in the management of severe epistaxis. Methods We report a double‐blinded randomized clinical trial, in which intervention was the ethmoid crest resection during electrocoagulation of the sphenopalatine artery. The study participants consisted of 42 patients with severe epistaxis and indication for surgical treatment, treated at the Otorhinolaryngology Emergency Room (ORL ER) of Hospital Sao Paulo, the teaching hospital of the Federal University of Sao Paulo. Results There was significant greater exposure of the arterial branch after removal of the ethmoidal crest ( p = 0.009). The rate of bleeding within 48 hours of the procedure was significantly lower in the crest removal group. Conclusion Resection of the ethmoid crest during sphenopalatine surgery proved to be feasible without additional risks, including promoting decrease in the overall surgical time. It provided better exposure of arterial branches of the sphenopalatine foramen, leading to a lower rebleeding rate within 48 hours.