Plasma knife sphenopalatine artery cauterization via lateral nasal wall incision for posterior epistaxis.

Background: Endoscopic sphenopalatine artery cauterization (ESPAC) has become an important method to manage posterior epistaxis.

Aims/objectives: To investigate the application of plasma knife and lateral nasal wall incision in ESPAC in the treatment of posterior epistaxis.

Material and methods: A retrospective study of 32 cases who underwent ESPAC for epistaxis was conducted. A vertical incision was made on the lateral nasal well to expose the sphenopalatine artery (SPA). The main branches of SPA were cauterized with a plasma knife or bipolar coagulation forceps. Cases were divided into plasma knife group (group PK) and bipolar group (group BP). The re-bleeding rates, operation time and the incidence of serious complication were compared between the two groups.

Results: ESPAC was successfully completed via a lateral nasal wall incision without maxillary antrostomy in all cases. All the patients were followed-up for 3 months, no serious complication was reported. There was no significant difference in re-bleeding rates and incidence of serious complication between the two groups. The operation time of group PK was shorter than group BP.

Conclusions and significance: Lateral nasal well incision without maxillary antrostomy is feasible for ESPAC. The application of a plasma knife may help to shorten the operation time.