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Surgical and interventional radiological management of adult epistaxis: systematic review.

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords

Epistaxis

Interventional

Ligation

Operative

Radiology

Surgical Procedures

Journal Title the journal of laryngology and otology
Publication Year Start




PMID- 29280696
OWN - NLM
STAT- MEDLINE
DCOM- 20180102
LR  - 20180102
IS  - 1748-5460 (Electronic)
IS  - 0022-2151 (Linking)
VI  - 131
IP  - 12
DP  - 2017 Dec
TI  - Surgical and interventional radiological management of adult epistaxis:
      systematic review.
PG  - 1108-1130
LID - 10.1017/S0022215117002079 [doi]
AB  - 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.
FAU - Swords, C
AU  - Swords C
AD  - Department of Otolaryngology,Addenbrooke's Hospital,Cambridge,UK.
FAU - Patel, A
AU  - Patel A
AD  - Department of Otolaryngology,Addenbrooke's Hospital,Cambridge,UK.
FAU - Smith, M E
AU  - Smith ME
AD  - Department of Otolaryngology,Addenbrooke's Hospital,Cambridge,UK.
FAU - Williams, R J
AU  - Williams RJ
AD  - Institute of Naval Medicine,Gosport,UK.
FAU - Kuhn, I
AU  - Kuhn I
AD  - University of Cambridge School of Clinical Medicine,UK.
FAU - Hopkins, C
AU  - Hopkins C
AD  - Department of Otolaryngology,Guy's and St Thomas' Hospital,London,UK.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PL  - England
TA  - J Laryngol Otol
JT  - The Journal of laryngology and otology
JID - 8706896
SB  - AIM
SB  - IM
MH  - Adult
MH  - Arteries/*surgery
MH  - Cautery/adverse effects/*methods
MH  - Embolization, Therapeutic/adverse effects/*methods
MH  - Epistaxis/*therapy
MH  - Humans
MH  - Ligation/adverse effects/*methods
MH  - Nose/*blood supply
MH  - Radiology, Interventional/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Epistaxis
OT  - Interventional
OT  - Ligation
OT  - Operative
OT  - Radiology
OT  - Surgical Procedures
EDAT- 2017/12/28 06:00
MHDA- 2017/12/28 06:00
CRDT- 2017/12/28 06:00
PHST- 2017/12/28 06:00 [entrez]
PHST- 2017/12/28 06:00 [pubmed]
PHST- 2017/12/28 06:00 [medline]
AID - S0022215117002079 [pii]
AID - 10.1017/S0022215117002079 [doi]
PST - ppublish
SO  - J Laryngol Otol. 2017 Dec;131(12):1108-1130. doi: 10.1017/S0022215117002079.