Abstract
During the period from 1971 to 2002, 48 patients with epistaxis underwent 54 surgical procedures on admission to Kitasato University Hospital. The age of the patients ranged from 17 to 83 years with an average of 44.8 years in males and 54.3 in females. Before admission, approximately half of the patients were unsuccessfully treated at other medical institutions. In those cases, the most common site of epistaxis was the posterior portion of the nasal cavity, although the exact spot of bleeding was often hardly identifiable. As for the general complications, the incidence of high blood pressure was most common, while there was also one case of Osler disease. Even after admission, 3 or more additional bleeding episodes were noted in 24 cases. MRA or selective arteriography was performed in 8 patients, but no positive findings were obtained. As the surgical procedure, clipping of the maxillary artery was performed in 43 patients, and ligation of the external carotid artiery was performed in 3 patients. In the patient with Osler disease, turbinectomy combined with electro-coagulation was performed. We concluded that surgical treatments should be performed for uncontrollable recurrent epistaxis from the posterior portion of the nasal cavity with unidenfiable spot of bleeding. The clipping of the maxillary artery was the most effective treatment in the present series.
