Cauterization of the Sphenoid Rostrum during SPA Ligation: Does This Technique Decrease Number of Subsequent Rebleeds?

Erratum: Special Virtual Symposium of the North American Skull Base Society

Background: Sphenopalatine artery (SPA) ligation represents a viable option for treating recurrent epistaxis. However, different approaches to SPA ligation and simultaneous procedures performed to increase success rates are often not reported on or analyzed in the literature.

Objectives: This study was aimed to review the sphenoid anatomy, outline the steps performed during cauterization of the sphenoid rostrum while performing a unilateral or bilateral SPA ligation, present the success rate of a concomitant sphenoidotomy, and this approach, and finally discuss possible reasons for rebleeding and stratify our conclusions based off of recorded risk factors.

Study Design: This is a retrospective chart review at a large academic center in a municipal city.

Subjects and Methods: A single-center, retrospective chart review from June 2015 to August 2020 of patients undergoing SPA ligation, sphenoidotomy, and sphenoid rostrum cauterization of the posterior septal branch of the SPA by seven surgeons for epistaxis control was performed. Baseline demographic data, previous medical management, comorbidities, risk factors, and anticoagulation status were collected on all 195 patients. Basic descriptive statistics and one-way analysis of variance (ANOVA) via SPSS 26 were used to generate our results.

Results: A total of 195 SPA ligation procedures were performed by seven surgeons between June 2015 and August 2020. Of those 195 patients, 184 (94%) also had a sphenoidotomy and their sphenoid rostrum cauterized. Of the 184 patients, 46 rebled (25%). Of the 11 patients who didn't undergo sphenoidotomy and cauterization, 8 rebled (73%). Long-term, not performing a sphenoidotomy and cauterization during SPA ligation was found to be nearly statistically significant (p = 0.051).

Conclusion: Based-off of a relatively small sample size, cauterization of the sphenoid rostrum leads to a decrease in the total number of rebleeds following SPA ligation.

Publication History

Article published online:
12 February 2021