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Surgical and interventional radiological management of adult epistaxis: Systematic review

Research output: Contribution to journalArticle

C. Swords, A. Patel, M.E. Smith, R.J. Williams, I. Kuhn, C. Hopkins

Original languageEnglish
Pages (from-to)1108-1130
Number of pages23
JournalJournal of Laryngology and Otology
Volume131
Issue number12
Early online date27 Dec 2017
DOIs
Publication statusE-pub ahead of print - 27 Dec 2017

Bibliographical note

Export Date: 16 July 2018

King's Authors

Abstract

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.

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