SPA ligation is generally indicated for intractable posterior epistaxis that does not settle following 24hrs of adequate anterior and posterior nasal packing, and for recur- rent unilateral epistaxis unrelated to an underlying systemic disease or a drug rela- ted blood dyscrasia.

What is endoscopic sphenopalatine artery ligation?

Background: Endoscopic sphenopalatine artery ligation (ESPAL) is the intervention of choice for refractory epistaxis in specialist ear, nose and throat (ENT)units and should be within the repertoire of competencies for all ENT trainees.

What is artery ligation?

With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a hemostat, then secure it by ligating it; i.e. using a piece of suture around it before dividing the structure and releasing the hemostat.

Where is the sphenopalatine artery located?

The sphenopalatine artery (SPA) serves as the major supply to the nasal fossa and enters the nasal cavity through the sphenopalatine foramen. The foramen is located on the posterior aspect of the lateral nasal wall posterior to the middle turbinate.

What is Crista Ethmoidalis?

The crista ethmoidalis is a small, raised bony crest just anterior or anterior-inferior to the sphenopalatine foramen. ▪ The crista ethmoidalis is located within 1 mm of the sphenopalatine foramen in 95% of cadaveric specimens.

What is endoscopic cauterization?

Endoscopic cauterization of SPA is technically straightforward to perform and allows direct cauterization of the major vessel supplying the posterior nasal cavity.

What is the sphenopalatine foramen?

The sphenopalatine foramen (SPF) represents an opening on the lateral nasal wall that is present at the articulation between the superior aspect of the vertical portion of the palatine bone and the inferior projection of the sphenoid bone.

What does Ligate mean in surgery?

Ligation means the surgical tying of veins through a small incision in the skin to prevent pooling of blood. Ligation may be used in conjunction with vein stripping, or removal of the vein. In many instances, the vein is removed using a minimally invasive surgical procedure called venous ablation.

What is carotid artery ligation?

Partial carotid artery ligation involves ligating all distal branches of the left carotid artery except the superior thyroid artery, creating a low-flow state with commensurate vascular remodeling over 2 or more weeks.

Which artery is ligated in epistaxis?

Ligation of the external carotid artery for severe epistaxis.

Where is the ethmoid artery?

The anterior ethmoid artery is a branch of the ophthalmic artery. It supplies the anterior and middle ethmoidal sinuses, frontal sinus, the lateral nasal wall and the nasal septum (see nasal cavity).

What artery is in your nose?

The arterial supply to the nose may be principally divided into (1) branches from the internal carotid, namely the branches of the anterior and posterior ethmoid arteries from the ophthalmic artery, and (2) branches from the external carotid, namely the sphenopalatine, greater palatine, superior labial, and angular

What is anterior ethmoid artery?

The anterior ethmoid artery is a branch of the ophthalmic artery. It supplies the anterior and middle ethmoidal sinuses, frontal sinus, the lateral nasal wall and the nasal septum (see nasal cavity).

What travels with the sphenopalatine artery?

The sphenopalatine artery is a terminal branch of the internal maxillary artery originating from the external carotid artery system. [4] The SPA is the major blood vessel to the nasal cavity mucosa: supplying the superior, middle, and inferior turbinate; lateral nasal wall; and nasal septum.

What is Little’s area of nose?

Little’s Area. Little’s area (also known as Kiesselbach’s plexus) is found on the anterior nasal septum (Fig. 1) and is an anastomosis of 5 arteries: anterior ethmoidal artery, posterior ethmoidal artery, sphenopalatine artery, greater palatine artery, and the septal branch of the superior labial artery.

Is an endoscopy a surgical procedure?

This type of surgery is performed using a scope, a flexible tube with a camera and light at the tip. This allows your surgeon to see inside your colon and perform procedures without making major incisions, allowing for easier recovery time and less pain and discomfort.

What is a cauterized artery?

Cauterization, or cautery, is a medical technique performed by a doctor or surgeon. During the procedure, they use electricity or chemicals to burn tissue in order to close a wound. It may also be done to remove harmful tissue. Wound cauterization is a routine procedure, but it’s not the first line of treatment.