Usefulness of endovascular treatment for delayed massive epistaxis following endoscopic endonasal transsphenoidal surgery: A case report

Tetsuo Oka, Kenji Sugiu, Joji Ishida, Tomohito Hishikawa, Shigeki Ono, Koji Tokunaga, Isao Date

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

We report here a case of massive nasal bleeding from the sphenopalatine artery three weeks after endonasal transsphenoidal surgery. This 66-year-old male suffered from massive nasal bleeding with the status of hypovolemic shock. Under general anesthesia, an emergent angiography revealed an extravasation from the sphenopalatine artery. Trans-arterial embolization using coil and n-butyl-cyanoacrylate (NBCA) was performed following the diagnostic angiography. Complete occlusion of the injured artery was achieved. The patient showed good recovery from general anesthesia. Delayed nasal bleeding after endonasal transsphenoidal surgery is a rare but important complication. The sphenopalatine artery and its branch are located in the hidden inferior lateral corner of the sphenoid sinus and may be injured during enlargement of the sphenoid opening. When massive delayed nasal bleeding follows transsphenoidal surgery and damage of the internal carotid artery has been ruled out, endovascular treatment of the external carotid artery should be considered.

Original languageEnglish
Pages (from-to)55-60
Number of pages6
JournalNeurological Surgery
Volume40
Issue number1
Publication statusPublished - Jan 10 2012

Fingerprint

Epistaxis
Arteries
General Anesthesia
Angiography
Cyanoacrylates
Sphenoid Sinus
External Carotid Artery
Internal Carotid Artery
Therapeutics
Shock

Keywords

  • Complication
  • Embolization
  • Endonasal transsphenoidal surgery
  • Endovascular treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Usefulness of endovascular treatment for delayed massive epistaxis following endoscopic endonasal transsphenoidal surgery : A case report. / Oka, Tetsuo; Sugiu, Kenji; Ishida, Joji; Hishikawa, Tomohito; Ono, Shigeki; Tokunaga, Koji; Date, Isao.

In: Neurological Surgery, Vol. 40, No. 1, 10.01.2012, p. 55-60.

Research output: Contribution to journalArticle

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