A case of severe postoperative epistaxis managed with super-selective intraarterial embolization.

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An 18-year-old male had intractable epistaxis from the posterior nasal cavity which could not be controlled by the conventional packing method after a bilateral modified Caldwell-Luc operation with exenteration of the ethmoid and simple conchotomy. Although the postoperative course had been uneventful, on the 8th day after surgery sudden and massive epistaxis occurred from the posterior part of the nasal cavity. This was controlled with conventional anteroposterior packing, which was 5 times untill the 28th postoperative day. In order to confirm the site of bleeding, angiography was performed by Sildinger's procedure through the right common carotid artery.The sphenopalatine artery which was found to be the site, was successfully embolized with small pieces of Gelform(R). No further epistaxis or complications of the embolism occurred. Therapeutic intraarterial embolization is a new and effective therapy of otherwise untreatable severe opistaxis.
耳鼻咽喉科臨床学会の論文