Anatomical variation of the posterior septal artery leads to refractory epistaxis.

IF 1.8 4区环境科学与生态学 Q2 FISHERIES Marine and Freshwater Research Pub Date : 2023-07-04 eCollection Date: 2024-09-01 DOI:10.1002/wjo2.113

Dong-Jiao An, Zu-Fei Li, Xiao-Chang Zhao, Jin-Feng Liu

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Abstract

Purpose: To report a rare variant of the posterior septal artery (PSA), which supplies blood to the posterior mucosa of the contralateral nasal septum.

Case report: A 31-year-old female patient underwent suture removal 14 days after septoplasty and developed left-sided epistaxis 6 h after suture removal. To safely and effectively relieve the patient from epistaxis, the cauterization of the left PSA was performed under general anesthesia. However, 24 h after the first surgical hemostasis, the patient experienced epistaxis again in the right nasal cavity. We have reviewed the patient's sinus computed tomography again and found a rare variant of PSA, which is the right-sided PSA passing through a bony canal in the left-sided nasal septum.

Discussion: The variant of PSA well explained the failure of the first hemostatic surgery. Therefore, we again performed a cauterization of the right-sided PSA, after which the patient recovered and no further epistaxis occurred.

Conclusion: When cauterization of PSA is used to manage posterior epistaxis, it is necessary to pay attention to the possible variation in PSA.

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鼻中隔后动脉的解剖变异导致难治性鼻衄。

目的：报告鼻中隔后动脉（PSA）的一种罕见变异，该动脉向对侧鼻中隔后部粘膜供血：一名 31 岁的女性患者在鼻中隔成形术后 14 天接受了拆线手术，拆线后 6 小时出现左侧鼻衄。为了安全有效地缓解鼻衄，患者在全身麻醉下接受了左侧 PSA 烧灼术。然而，第一次手术止血 24 小时后，患者右侧鼻腔再次出现鼻衄。我们再次查看了患者的鼻窦计算机断层扫描，发现了一种罕见的 PSA 变异，即右侧 PSA 穿过左侧鼻中隔的骨性管道：讨论：PSA 的变异很好地解释了第一次止血手术的失败。因此，我们再次对右侧的 PSA 进行了烧灼，术后患者恢复良好，没有再发生鼻衄：结论：在使用 PSA 烧灼术治疗后鼻衄时，有必要注意 PSA 可能存在的变异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Marine and Freshwater Research 环境科学-海洋学

CiteScore

4.60

自引率

5.60%

发文量

审稿时长

3.8 months

期刊介绍： Marine and Freshwater Research is an international and interdisciplinary journal publishing contributions on all aquatic environments. The journal’s content addresses broad conceptual questions and investigations about the ecology and management of aquatic environments. Environments range from groundwaters, wetlands and streams to estuaries, rocky shores, reefs and the open ocean. Subject areas include, but are not limited to: aquatic ecosystem processes, such as nutrient cycling; biology; ecology; biogeochemistry; biogeography and phylogeography; hydrology; limnology; oceanography; toxicology; conservation and management; and ecosystem services. Contributions that are interdisciplinary and of wide interest and consider the social-ecological and institutional issues associated with managing marine and freshwater ecosystems are welcomed. Marine and Freshwater Research is a valuable resource for researchers in industry and academia, resource managers, environmental consultants, students and amateurs who are interested in any aspect of the aquatic sciences. Marine and Freshwater Research is published with the endorsement of the Commonwealth Scientific and Industrial Research Organisation (CSIRO) and the Australian Academy of Science.