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We now perform endoscopic ligation of the sphenopalatine artery on patients with severe or intractable epistaxis.
If the septal branch of the sphenopalatine artery is encountered, it can be cauterized by bipolar diathermy.
A branch of the sphenopalatine artery at the level of the choana was identified and bleeding was controlled with suction electrocautery.
When the pack failed to control the epistaxis the patient would be taken to theatre for localisation of the bleeder and diathermy, or endoscopic sphenopalatine artery ligation.
Sphenopalatine artery (greater incisive artery) septal branch irrigation emerges in the incisive papilla area providing irrigation for the nasal septum; this is mixed with the superior lip and ophthalmic artery and also vasomotorinnervated by the SG.
Multiple surgical procedures have been tried in the past, including endoscopic ligation of the sphenopalatine artery (ELSPA), which is considered an effective surgical modality in the management of epistaxis.
Management of posterior epistaxis by endoscopic clipping of the sphenopalatine artery.
Anatomically, the sphenopalatine artery branches into the septum and approaches Kiesselbach's plexus from a posterior direction (figure 1).
If the sphenopalatine artery was evident through the sphenopalatine foramen, it was cauterized.