Publication:

Management of intractable epistaxis in a tertiary care referral hospital: an observational study

Background The aim of this study is to evaluate the effectiveness of sphenopalatine artery ligation/ cauterisation as a surgical intervention in control of refractory epistaxis and achieving haemostasis.

Methods The study was done with patients in the Department of ENT, Head and Neck surgery Health care hospital and out station referrals from institution’s outreach clinics, for a period of 2 years (May 2020-April 2022).  Patients with recurrent epistaxis, not controlled by digital pressure, anterior packing (ribbon gauze/ merocele) or postnasal packing were taken up for emergency endoscopic sphenopalatine artery ligation/cauterisation under general anaesthesia. Effectiveness of this technique was established by routine endoscopic follow up of these patients over a period of 6 months post procedure.

Results Out of a total of 55 patients who presented with recurrent epistaxis, 8 patients settled down with conservative management (digital pressure/external ice pack application), 18 patients settled down with anterior nasal packing, 12 patients settled down with anterior and posterior nasal packing and 17 patients required sphenopalatine artery ligation/cauterization. None of these postop patients had any further episodes of nasal bleed.

Conclusions Sphenopalatine artery ligation has proven to be an effective measure in control of intractable refractory epistaxis when compared to therapeutic embolization or other procedures.