What is sphenopalatine artery ligation

An endoscopic transnasal approach for ligation of the terminal branch of the internal maxillary artery

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 does the sphenopalatine artery supply?

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.

How do you Spgate the sphenopalatine artery?

An incision is made just posterior to the posterior attachment of the middle turbinate. The mucosal flap is then carefully elevated to reveal the sphenopalatine artery, which is then clipped and ligated.

How do you find the sphenopalatine artery?

The location of the sphenopalatine foramen (SPF) is identified within the superior meatus after elevation of a mucoperiosteal flap and identification of the crista ethmoidalis from the posterior aspect of the middle meatus. Opening the maxillary sinus may assist the surgeon if these landmarks are not quickly found.

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.

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 is the difference between anterior and posterior epistaxis?

Anterior nosebleeds originate toward the front of the nose and cause blood to flow out through the nostrils. This is the most common type of nosebleed and it is usually not serious. Posterior nosebleeds originate toward the back of the nasal passage, near the throat.

What is a spa ligation?

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 cauterization?

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

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Why is Sphenopalatine artery called artery of epistaxis?

The sphenopalatine artery, formerly known as the nasopalatine artery, is the terminal branch of the maxillary artery that is the main supply to the nasal cavity. It is colloquially know as the artery of epistaxis given its common involvement in cases of nose bleeds.

Which artery is called artery of epistaxis?

Sphenopalatine arterySourcemaxillary arteryBranchesposterior lateral nasal branches posterior septal branches

What is the main source of arterial blood to the nose?

The blood that perfuses the nose is mainly from branches of the facial artery. The branches of the facial artery and the superior labial artery perfuse the nose via the septal branches, the angular artery, the external nasal artery, the dorsal nasal artery, and the lateral nasal artery.

Where is Little's area?

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.

How do you remember maxillary arteries?

A mnemonic for remembering the branches of the maxillary artery is: DAM I AM Piss Drunk But Stupid Drunk I Prefer, Must Phone Alcoholics Anonymous.

What are the branches of facial artery?

On the face, four main vessels arise from the trunk of the facial artery: the inferior labial artery, superior labial artery, lateral nasal branch (to the nasalis), and the angular artery. [4] The angular artery is the terminal segment of the facial artery.

How do you do a sphenopalatine block?

1. Inject 0.5 mL of 2% viscous lidocaine into each nostril with the open end of a 3 mL syringe (without needle). Have the patient sniff to draw the anesthetic posteriorly.
2. Use an atomizer to draw up 1 mL of 1% lidocaine per naris and aerosolize into each naris. Remember, you can administer a maximum of 1 mL per naris.

What is the Palatine Canal?

The greater palatine canal (or pterygopalatine canal) is a passage in the skull that transmits the descending palatine artery, vein, and greater and lesser palatine nerves between the pterygopalatine fossa and the oral cavity.

What is Hypogastric artery ligation?

Hypogastric (internal iliac) artery ligation was pioneered by Howard Kelly for the treatment of intraoperative bleeding from cervical cancer prior to its application in postpartum hemorrhage (PPH). Many studies have reported that hypogastric artery ligation can be life-saving in patients with massive pelvic bleeding.

Which artery is ligated in anterior epistaxis?

Ligation of the external carotid artery for severe epistaxis.

Where is Ethmoidal artery?

The anterior ethmoidal artery, is a branch of the ophthalmic artery in the orbit. It exits the orbit through the anterior ethmoidal foramen. The posterior ethmoidal artery is posterior to it.

Where does the anterior ethmoidal artery come from?

The posterior and anterior ethmoidal arteries typically arise from the third segment of the ophthalmic artery and course through the medial orbit before passing through the posterior and anterior ethmoidal canals, respectively, into the ethmoid air cells.

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 are the three types of epistaxis?

An anterior nosebleed occurs when the blood vessels in the front of the nose break and bleed. A posterior nosebleed occurs in the back or the deepest part of the nose. In this case, blood flows down the back of the throat. Posterior nosebleeds can be dangerous.

How do you fix a posterior nosebleed?

1. remain calm.
2. sit upright, to keep the head above heart level.
3. lean forward, to prevent blood entering the throat.
4. gently blow out any clotted blood.
5. use a nasal decongestant spray, such as oxymetazoline or neo-synephrine.

How do you treat an anterior nosebleed?

1. sit down and firmly pinch the soft part of your nose, just above your nostrils, for at least 10-15 minutes.
2. lean forward and breathe through your mouth – this will drain blood into your nose instead of down the back of your throat.

Can an artery be cauterized?

Cauterizing Arteries in Laparoscopic Cholecystectomy Can Be Both Unnecessary and Dangerous. April 15, 2008 (Philadelphia) — Almost since the inception of laparoscopic cholecystectomy, surgeons have been employing devices that concentrate electrical or vibrational energy to heat and thereby cauterize arteries.

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 it called when you burn a wound closed?

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.

What artery supplies the upper lip?

Background: The superior labial artery, which is a branch of the facial artery, supplies the upper lip area.

What does it mean when you have dry blood in your nose?

The most common cause of nosebleeds is dry air. Dry air can be caused by hot, low-humidity climates or heated indoor air. Both environments cause the nasal membrane (the delicate tissue inside your nose) to dry out and become crusty or cracked and more likely to bleed when rubbed or picked or when blowing your nose.