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Title: Resection of the ethmoidal crest in sphenopalatine artery surgery
Authors: Neto, Paulo Saraceni [UNIFESP]
Nunes, Leonardo Mendes Acatauassu [UNIFESP]
Caparroz, Fábio de Azevedo [UNIFESP]
Gregorio, Luciano Lobato [UNIFESP]
Souza, Rafael de Paula e Silva Felice de [UNIFESP]
Simoes, Juliana Caminha [UNIFESP]
Kosugi, Eduardo Macoto [UNIFESP]
Keywords: epistaxis
nasal surgical procedures
sphenopalatine artery
ethmoidal crest
endonasal surgery
Issue Date: 2017
Publisher: Wiley
Citation: International Forum Of Allergy & Rhinology. Hoboken, v. 7, n. 1, p. 87-90, 2017.
Abstract: Background: In severe cases of epistaxis, in spite of several procedures described in the literature for its management, surgical treatment has been recognized by most authors as 1 of the most effective, especially when it includes ligation and/or electrocoagulation of the nasal branches of the sphenopalatine artery. The objective of this study is to determine the importance of ethmoid crest resection during sphenopalatine artery surgery, in the management of severe epistaxis. Methods: We report a double-blinded randomized clinical trial, in which intervention was the ethmoid crest resection during electrocoagulation of the sphenopalatine artery. The study participants consisted of 42 patients with severe epistaxis and indication for surgical treatment, treated at the Otorhinolaryngology Emergency Room (ORL ER) of Hospital Sao Paulo, the teaching hospital of the Federal University of Sao Paulo. Results: There was significant greater exposure of the arte-rial branch after removal of the ethmoidal crest (p= 0.009). The rate of bleeding within 48 hours of the procedure was significantly lower in the crest removal group. Conclusion: Resection of the ethmoid crest during sphenopalatine surgery proved to be feasible without additional risks, including promoting decrease in the overall surgical time. It provided better exposure of arterial branches of the sphenopalatine foramen, leading to a lower rebleed-ing rate within 48 hours. (C) 2016 ARS-AAOA, LLC.
ISSN: 2042-6976
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