난치성 후방 비출혈 환자에서 내시경하 접형구개동맥 소작술과 선택적 동맥 색전술의 비교 분석
Comparative Analysis for Endoscopic Sphenopalatine Artery Electrocauterization and Selective Arterial Embolization in Patients with Intractable Posterior Epistaxis
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The purpose of this study was to compare treatment modality of ESPAL and arterial embolization in patients with intractable posterior epistaxis. Subjects and Methods：This study was a retrospective review of 16 patients with intractable posterior epistaxis. Twelve patients were treated with ESPAL and four patients with arterial embolization. Success rates, duration of procedure, hospital stay, hospital cost, postoperative complications were analyzed. Results：Rebleeding occurred in two patients treated with ESPAL. One patient was successfully controlled with reoperation. The other surgical failure was controlled with embolization due to SPA pseudoaneurysm. The success rate of ESPAL and embolization was 83.3% and 100%, respectively. Two of four patients received embolization had pseudoaneurysm in the descending palatine artery. The mean duration of procedure and hospital stay was 82.5 minutes and 8.1 days in ESPAL, but 96.7 minutes and 6.0 days in embolization, respectively. The mean total cost of ESPAL was 3,380,000 won, 4,090,000 won for embolization. There were no major complications in both groups. Conclusions：Both ESAPL and arterial embolization had similar high success rates in controlling intractable posterior epistaxis. However, arterial embolization may be a better initial option in patients suspected of pseudoaneurysm and in surgical failures.
Abstract
The purpose of this study was to compare treatment modality of ESPAL and arterial embolization in patients with intractable posterior epistaxis. Subjects and Methods：This study was a retrospective review of 16 patients with intractable posterior epistaxis. Twelve patients were treated with ESPAL and four patients with arterial embolization. Success rates, duration of procedure, hospital stay, hospital cost, postoperative complications were analyzed. Results：Rebleeding occurred in two patients treated with ESPAL. One patient was successfully controlled with reoperation. The other surgical failure was controlled with embolization due to SPA pseudoaneurysm. The success rate of ESPAL and embolization was 83.3% and 100%, respectively. Two of four patients received embolization had pseudoaneurysm in the descending palatine artery. The mean duration of procedure and hospital stay was 82.5 minutes and 8.1 days in ESPAL, but 96.7 minutes and 6.0 days in embolization, respectively. The mean total cost of ESPAL was 3,380,000 won, 4,090,000 won for embolization. There were no major complications in both groups. Conclusions：Both ESAPL and arterial embolization had similar high success rates in controlling intractable posterior epistaxis. However, arterial embolization may be a better initial option in patients suspected of pseudoaneurysm and in surgical failures.
참고문헌 (12)
- 이현순, "내시경하 비강내 접형구개동맥의 결찰 또는전기소작을 통한 후방 비출혈의 치료", 대한이비인후과학회지 두경부외과학, 48(7), pp.882~887 (2005), 대한이비인후과학회
- 윤성원, "조기 내시경하 접형구개동맥 소작술을 통한 난치성 비출혈의 치료: 예비 연구", Journal of Rhinology, 21(2), pp.112~118 (2014), 대한비과학회
- Rudmik L, "Management of intractable spontaneous epistaxis", Am J Rhinol Allergy, 26(1), pp.55~60 (2012)
- Dedhia RC, "Cost-effectiveness of endoscopic sphenopalatine artery ligation versus nasal packing as first-line treatment for posterior epistaxis", Int Forum Allergy Rhinol, 3(7), pp.563~566 (2013)
- Christensen NP, "Arterial embolization in the management of posterior epistaxis", Otolaryngol Head Neck Surg, 133(5), pp.748~753 (2005)
- Jindai G, "Interventional neuroradiology applications in otolaryngology, head and neck surgery", Otolaryngol Clin North Am, 45(6), pp.1423~1449 (2012)
- Goddard JC, "Inpatient management of epistaxis:outcomes and cost", Otolaryngol Head Neck Surg, 132(5), pp.707~712 (2005)
- Traboulsi H, "Changing trends in the management of epistaxis", Int J Otolaryngol, 2015, pp.263987~ (2015)
- Avelar RL, "Embolization of pseudoaneurysm of the internal maxillary artery after orthognathic surgery", J Cranifac Surg, 21(6), pp.1764~1768 (2010)
- 정다운, "양악 수술 후 발생한 가성동맥류로 인한 대량 비출혈 치험 1예", 임상이비인후과, 24(2), pp.238~241 (2013), 대한이비인후과학회 부산,울산,경남 지부회
- Woo CK, "A case of pseudoaneurysm of the sphenopalatine artery presenting intractable epistaxis", J Clinical Otolaryngol, 20(1), pp.243~246 (2009)
- 최명수, "선택적 동맥 색전술을 이용한 난치성 재발성 비출혈 환자의 치료: 임상양상 분석 및 문헌고찰", 대한이비인후과학회지 두경부외과학, 58(4), pp.257~260 (2015), 대한이비인후과학회[DOI]