Endoscopic Cauterization Versus Clipping of Sphenopalatine Artery in the Management of Intractable Posterior Epistaxis

Abstract
Background: Endoscopic ligation of the sphenopalatine artery is a safe, simple and effective procedure in the man-agement of refractory posterior epistaxis. Both modalities (cauterization, clipping) show good efficacy in controlling posterior epistaxis with slight advantage of clipping that it showed less post-operative complications.
The Aim of study: This work was to compare the efficacy of endoscopic sphenopalatine artery cauterization versus clipping in the management of intractable posterior epistaxis.
Patients and Methods: Forty patients were selected for this prospective study in the period between October 2016 to April 2017 at Otolaryngology Department, Tanta University Hospital complaining of recurrent epistaxis (26 males and 14 females). The patient ages ranges between 18-60 years. We selected patients who didn't have history of sinonasal trauma, tumours or bleeding disorders. Twenty patients of the study had an endoscopic sphenopalatine artery clipping, the other twenty had sphenopalatine artery cauterization. The choice between the two surgical techniques has been randomized and all patients have been operated by the same doctor.
Results: Among the first group who had SPA cauterization 5 patients had recurrent epistaxis in the 4th, 5th, 6th, 8th day and after 1 month respectively thus success rate among this group is 75%. Two patients in the group who had sphenopal-atine artery clipping had recurrent epistaxis in the 6th and 7th day with success rate 90%.
Conclusions: Both modalities (cauterization, clipping) show good efficacy in controlling posterior epistaxis with slight advantage of clipping that it showed less post-operative complications.