Name of the Procedure:

Nasal/Sinus Endoscopy, Surgical; with Ligation of Sphenopalatine Artery

Summary

Nasal/sinus endoscopy with ligation of the sphenopalatine artery is a surgical procedure performed to control severe nosebleeds by sealing off the artery that supplies blood to the nasal cavity. The procedure is conducted using an endoscope, a thin, flexible tube with a camera.

Purpose

This procedure addresses severe and recurrent nosebleeds (epistaxis) that do not respond to less invasive treatments. The goal is to stop the bleeding by ligating (tying off) the sphenopalatine artery, thus reducing the blood flow and preventing further episodes.

Indications

• Severe, recurrent nosebleeds
• Nosebleeds unresponsive to conservative treatments (e.g., nasal packing, cauterization)
• Patients with underlying conditions that exacerbate nosebleeds, such as hypertension or blood clotting disorders

Preparation

• Patients may be advised to fast for several hours before the procedure.
• Medication adjustments may be necessary, particularly for blood thinners.
• Pre-procedure diagnostic tests could include blood tests and imaging studies like CT scans to assess the anatomy and pathology of the nasal cavity.

Procedure Description

1. The patient is placed under local or general anesthesia.
2. An endoscope is inserted into the nasal cavity to visualize the area.
3. The surgeon identifies the sphenopalatine artery.
4. Using specialized instruments, the artery is ligated (tied off) to stop the blood flow.

5. The endoscope is then carefully withdrawn, and the nasal passage is checked for bleeding control.

   Duration

   The procedure typically takes about 30 minutes to an hour.

Setting

Usually performed in a hospital or surgical center.

Personnel

• ENT (Ear, Nose, and Throat) surgeon
• Anesthesiologist
• Surgical nurses
• Technicians

Risks and Complications

• Bleeding or infection at the surgical site
• Damage to surrounding tissues or structures
• Reaction to anesthesia
• Rare complications such as numbness or changes in nasal airflow

Benefits

• Effective management and control of severe nosebleeds
• Immediate reduction in nosebleed frequency and intensity
• Relief from the anxiety and inconvenience of recurrent nosebleeds

Recovery

• Post-procedure care will include nasal packing and instructions to avoid activities that might strain the nose.
• Patients might experience mild discomfort or nasal congestion.
• Recovery time is usually a few days, with follow-up visits scheduled to monitor healing.

Alternatives

• Non-surgical options like nasal packing, cauterization, or embolization
• Pros of alternatives include less invasiveness and quicker recovery, but they may be less effective for severe cases.
• Cons include the potential for recurrent bleeding, requiring eventual surgical intervention.

Patient Experience

• Patients will be under anesthesia, so they should not feel pain during the procedure.
• Mild discomfort and congestion are common post-procedure.
• Pain management includes prescribed medications and over-the-counter pain relief.