Rapid hemostasis: a novel and effective outpatient procedure using microwave ablation to control epistaxis of isolated mucosal bulge lesions

Revista Brasileira de Otorrinolaringologia

article

Zheng Cai Lou¹ 

[1] Yiwu Central Hospital, Department of Otorhinolaryngology

关键词: Epistaxis;    Microwaves;    Nasal mucosa;    Nasal septal perforation;   

DOI  :  10.1016/j.bjorl.2019.09.002

学科分类：医学（综合）

来源: Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial

【 摘 要 】

Introduction: Recurrent epistaxis is commonly encountered in the rhinology outpatient clinic. Under endoscopic guidance, both bipolar cautery and monopolar forceps (combined with suction) have been employed to control the bleeding. However, the use of monopolar forceps requires the placement of grounding pads. Most procedures are currently performed in operating rooms. Objective: We investigated outcomes after the use of Microwave Ablation (MWA) to control epistaxis in adults with isolated mucosal bulge lesions. All procedures were performed with patients under local anesthesia in our outpatient clinic. Methods: This is a retrospective cohort study. We included 83 adults with epistaxis of isolated mucosal bulge lesions. Microwave ablation was performed in the outpatient clinic to control bleeding, after induction of local anesthesia. The primary outcome was successful hemostasis. The secondary outcomes were the rebleeding rates at weeks 1 and 4 and month 6, and complications (crust or synechiae formation, septal perforation, and/or orbit or brain complications). Results: All bleeding points were successfully ablated; hemostasis was achieved within 1---2 min. The mean pain score was 1.83 intra-operatively and 0.95 1 h postoperatively. No patient re-bled, and no severe MWA-related complication (septal perforation, synechiae formation, or orbit or brain complication) was recorded to 6 months of follow-up. Conclusions: Endoscopic microwave ablation with patients under local anesthesia is a novel, safe, effective, rapid, well-tolerated, outpatient treatment for adults with epistaxis of isolated mucosal bulge lesions, especially those for whom general anesthesia might be risky, those with electrical implants, and those exhibiting contraindications for arterial embolization. © 2021 Associac¸ao˜ Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. ´ Published by Elsevier Editora Ltda. This is an open access article under the CC BY license.

【 授权许可】

CC BY