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Sphenopalatine artery surgery for refractory idiopathic epistaxis: Systematic review and meta‐analysis
Author(s) -
Kitamura Takahiro,
Takenaka Yukinori,
Takeda Kazuya,
Oya Ryohei,
Ashida Naoki,
Shimizu Kotaro,
Takemura Kazuya,
Yamamoto Yoshifumi,
Uno Atsuhiko
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27767
Subject(s) - cauterization , medicine , perioperative , ligation , surgery , confidence interval , refractory (planetary science) , complication , anesthesia , physics , astrobiology
Objectives Epistaxis, especially posterior epistaxis, is occasionally refractory to treatment. In these cases, sphenopalatine artery surgeries, including cauterization and ligation, are required. Previous reports have demonstrated treatment results for these procedures but failed to provide high‐level evidence. The aim of this study was to quantify the rates of failure and perioperative complications of these procedures by using a meta‐analysis technique. Methods We systematically searched electronic databases and identified articles regarding epistaxis, sphenopalatine artery ligation, or cauterization. Pooled rebleeding and complication rates were calculated by using a random effects model. Results A total of 896 cases of sphenopalatine ligation or cauterization for epistaxis were analyzed. Pooled rebleeding rates for the entire cohort, cauterization group, and ligation group were 13.4% (95% confidence interval [CI] 10.0–17.8, P < 0.001), 7.2% (95% CI 4.6–11.0, P < 0.001), and 15.1% (95% CI 9.8–22.5, P < 0.001), respectively. Pooled perioperative complication rates for the entire cohort, cauterization group, and ligation group were 8.7% (95% CI 4.9–15.1, P < 0.001), 10.2% (95% CI 3.8–24.5, P < 0.001), and 6.4% (95% CI 1.8–20.9, P < 0.001), respectively. Conclusion Overall, sphenopalatine surgery for refractory epistaxis is an effective method because of its low rates of failure and complications. Cauterization is more effective than ligation, whereas complications are comparable between the two procedures. Laryngoscope , 129:1731–1736, 2019