Outcomes of sphenopalatine and internal maxillary artery ligation inside the pterygopalatine fossa for posterior epistaxis.

OBJECTIVE: Analysis of the efficacy of sphenopalatine artery (SPA) and internal maxillary artery (IMAX) ligation within the pterygopalatine fossa to control posterior epistaxis.

METHODS: Demographic and clinical data were collected in sixty-two consecutive patients who had SPA/IMAX ligation surgery. Clinical outcomes such as re-bleed rates and complications were acquired.

RESULTS: A total of 62 patients were studied. Thirty-eight percent of patients had previously undergone silver nitrate nasal cautery for epistaxis. Nine patients had undergone previous attempt of SPA procedure or embolization in other services. Two patients returned to the operating room for anterior ethmoid ligation. There was one mortality within 30 days of surgery. Follow up ranged from 3 months to 56 months (median= 28 months).

CONCLUSIONS: Dual SPA and IMAX ligation is effective in the control of difficult epistaxis cases, even in those patients with prior surgical intervention.